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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 —www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> i(10 L <br /> PROJECT ADDRESS <br /> ya S- <br /> c 1] 11dny 3 `l7-3X17' <br /> -7AN!<< l� !`1,,•, , ,�02 6/"STSG Fvz.t � <br /> Owner <br /> Mail Address City State/Zip Phone <br /> Tenant <br /> Mail Address City State/Zip Phone <br /> 360 <br /> 1�, I en tiK�lZ/L IZq N 1S1A2LINLTAO 41A, of ZZ3 `/.33`5'7LL_ <br /> Electrical Contractor Mail Address city State/Zip Phone <br /> `>ONNC-�Io ��ti� Z %o a <br /> ate tejLicensse Number Contract Price of Work <br /> v F`-__ Contact Person (Plan Review) <br /> Proposed Use of Building <br /> Description of Work to Be Done: K K I"�/L I J I N cI Qcy1H PF �S I-'D r�tJ L I G tcTS <br /> alae i (AAVE �IRGut�j g14 t112no NAJST FA_�( I.e�� wt l i- <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEF <br /> BE IN RACEWAYS,MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODI3 IS 3105 ' 10-. _(� ) <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 goveminp9(Ills type of work will be completed <br /> whether specified herein or not. The granting of a permit does not P resume to give authority to <br /> violefe or cancel the provisions of any other state or local law regulating construction or the <br /> performance o/consprucIf n. That I am authorized by the owner of this roperty to perlomt the <br /> work for which applicafl s made end I comply with the State Confractors Law 18.27 RCW and <br /> 296.200 W C. <br /> 6 <br /> Signature et <br />