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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 y --09 `o % <br />425-257-8810 - FAX 425-257-8857 -www.everettwa.org C-7olt��(�3 <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM v7 <br />:2 115 lZ%4�-tt- <br />PROJECT ADDRESS <br />4-zs - <br />u rA ZITS <br />OINner Mad Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />lr�yw-Pi ,IitCIV C 3�d �haa�ccF AK f r�;�UnCf421 <br />Electrical Contractor Mail Address City Stfireizi Phone <br />State License Number Contra6 Once of Work <br />Promod Use oBuilding Co� Person (Plan Review) <br />Description of Work to Be Done �✓1-S TL TTC�,1 "• G1 r6u I* <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 7105 <br />l hereby teddy 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 or work will be completed <br />whether specified harem or not. The granting of a pemid does not presume to give authority to <br />violate or cancel the provisons of any other state or local law regulating construction or the <br />pedumwnce of construction That I am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 18 27 RCW and <br />296 29 MAC. <br />d& ti o 7 E-o-iol-H q3 <br />azure Da <br />