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Jan. 9. 201210: 12AM No. 2556 P. 4/4 <br /> i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES j <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425.257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED PROM 8 AM TO 4 PM <br /> C-izo ;T <br /> .2 55 t" c2 SvJ q $?()3 <br /> PROJECT ADDRESS <br /> OcaolUn At45 <br /> Owner Mall Address City SlatelZip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> cm LV WAR 9 20 I L-, Qq &G&(,v <br /> Electrical Contractor tdall Address City Stata/Zip Phone <br /> CMISMHIP 01G?q 25 <br /> State License Number Contract Price of Work <br /> Proposed se of Building 1 /' Contact Person (Plan Review) <br /> Desctiptlon of Work to 8e Done. ` NI2 , �Q <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> ©E IN RACEWAYS. MC OR AC CABLE. <br /> CITY or EVERETT LOCAL SALES TAX CODE IS 7105 <br /> 1 hereby,certify,that I have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be eomplefed <br /> whether specified herein or not. Tile granting of o permit does not presume to give authonfy to <br /> wofppto or cantv1 the pprovisions c any other state or local low regulating construction or the <br /> peAormancetof coostrucbon. That t am authorized 0y Ina ownor of this roparty to perform the <br /> work for which application is made and I comply with the State Contractors Lew 18.27 RCW end <br /> 298.200 WAC. <br /> 1a )il► fX1utl� c -g L2 <br /> ignalure �� Date <br />