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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -wvnv.everelhva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> PROJECT ADDRESS (� <br /> rI <br /> �QC.IL`�UI'N Pvytar , +1A1 ICS. 13rX y� { Suilrnt.v Sit IU�Q 17 '1 <br /> Owner MAJAddress City Stateop Phone <br /> yzr-232 .6 <br /> t n QAt A— <br /> Tenant Mall Address city Stateop Phone <br /> 1�40 r77QA-;L 7-flb Plt`1CC4- 1:�14 t.-JA— gN01 zj?, -151. %)7 <br /> Electrical Contractor Mall Address city State2lp Phone <br /> State License Number Contract Price of Work <br /> I'SF K <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: lflncr0 >r"i rA <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have read ana examined thls applfcation end know the same to be true and <br /> correct. All provrstons of laws and ordinances goveming this type of work will be completed <br /> whether speafied herein or not. The granting of s permd does not presume to give authority to <br /> violate or cancel the provisions o/any other stele or local law regulating construction or the <br /> performance o/construction. That I am authorized by the owner o/this property to perform tha <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> "LlL;,L., j c.nli. ,` 11 is LI <br /> Sipnnture Date <br /> r51 � -Ol�j <br />