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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.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM G -a -> '-07 <br />,2 ; ? 7-/ 5T s r <br />PROJECT ADDRESS <br />Rose /1e5 ':�lGl rnj'/ a A4 <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Pn:� <br />4PPCG 5-r4Ti' C Y1 '7� 76/1"Si5w "k l f-c Gv� 'M27'5- --/ <br />Electrical Contractor Mail Address City Stale/Zip Phone <br />APPL r SF 4) s <br />Slate License Number <br />Proposed Use of Building <br />Description of Work to Be Doric: if - e / c. e <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 />_s7-5 .00 <br />Contract Price of Wort. <br />Contact Person (Plan Review) <br />I hereby certify that I have road and examined this application and know the same to be (rue and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not Tho granting of a permit does not presume to give authodq to <br />violafo or cancel the PPrevisions of any other state or local law regulating construction or the <br />performance of constmc(lon. That 18177 authorized by the owner of (his property to pedomm the <br />work for which applrcafion is made and I comply with the State Contractors Law 18.27 RCW and <br />296, 20p WAC. <br />i <br />FEE <br />f0'706 -133 <br />