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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3206 CEDAR STREET, EVERETT, WA 913201 a -�O <br /> 425-257-8810 - FAX 425-257-8857 -wvrrv.everettwa.org 3 - <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROJECT ADDRESS Cc�L�)35 3-I S 3 <br /> G `d 2A_3 <br /> Owner Mall Address City State/7Jp Phone <br /> fjCCLr-b e- 2212 52. b i!E 5ruc t C_'?;ZD 3 <br /> Tenant 1�1 Mail Address City Stalemp Phone <br /> Electrical Contractor Mail Address City Statemp he"" <br /> Stale License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: X � t^t7 a <br /> GX�S+�a �1n GOcS Monti Bx�Grlor �a� 1 ur <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 /> 1119,01 <br /> certify that I have reed and examined this application and know the some to be true and <br /> correct All provisions of laws and or•lfnances governing this type of work will be completed / <br /> whether specl8ed herein nr not. lite granting of a permit does not presume to give authortfy to n Z <br /> violate or cancel the``+rovlslons of any other state or local law regulating construction or the <br /> performance of construction. The(I am aufhortzed by the owner of this mperty to perform the l <br /> work for which app8caflon is made and 1 comply with the State Contractors Lew 18.27 RCW and <br /> 296.200 WAC. <br /> % x.P 3� <br /> Signalur9' ale <br />