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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES S_a9 og <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257.8857 — www.everettwa.org r950 S —I <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 FM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />._�zk <br />PROJECT ADDRESS <br />0T-u \ R 6srs`k 2l2( 11,1'-ST C-v� t WA`ifi2d3 425 •33o-Fb9 <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />Mall Address <br />City <br />State/Zip Phone <br />�CL--staN i aaihz T,,,if, ?_23O Alb)- S Axns ya-fr--. L)A 98-263 <br />Electrical Contractor Mai: Address City State/Zip P'ione <br />Nr5TCI= 983cw _ <br />State License Number <br />r,-n <br />Proposed Use of Building <br />Description of Work to Be Done: <br />ex <br />C <br />NOTE. WIRING IN NON -DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contract Price of Work <br />Contact Person (Plan Review) <br />I 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 governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not resume to give authority to <br />violate or cancel the provisions of any other state or local law regulating constnrction or the <br />performance of construction. That/ am authorized by the owner of this property to perform the <br />work to, whic'+ application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />N <br />FEE <br />E C)gDS-135 <br />