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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.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />• c (03'� Sfi S� <br />PROJECT ADDRESS <br />i i(� I��vµc s L l C Itiat. St S�1 rycx a q$?t ((Yzr)29� 76 <br />Owne Man Address city State/Zip Phone <br />Tenant Mail Address city State/Zip Phone <br />1'DVJe,V_ 012LAY'i L 1 SR (;') 11 f— MC Ids To ( rA ( i n W 4 91 Z7 ( <br />Electrical Contractor Mau Address city State/Zip Phone <br />nxv fZl q0—. <br />State License Number Contract Price of Work <br />VA-4j S>=2 fQi11A i% ►�laAl2 +r Da-(R_ MAU o L (I14 S <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: �kiris 4 LAJp�' <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 />1 hereby certify that I have read and examined th!s application and know file same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel Ilia previsions of any other state or local law regulating construction or the <br />performance or construction. That I am authorized by the owner of this roperty to perform the <br />for which applicaflo Is made and I comply with the State Contractors Lew 18.27 RCW and <br />.200 WAC. <br />2 ZvLo <br />Signaturo Difte <br />