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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 L- 0904-II 5 <br />PROJECT ADDRESS <br />.1 <br />Owner Mail Address City State/Zip Phou.. <br />Tenant Mail Address City %dZ Staterop Phone <br />AkA C-letAyw, iQ Z4 1C k(-vt-a) /mac r %.,xoku.14h l c '67N D Electrical Contractor Mail Address �(�—j ily Stale/Lp - Phone <br />�l hELCL�Imo;NI� z p. <br />Slate License Number Contract Price of Work <br />Proposed Use of Building 1 Contact Person (Plan Review) (� <br />Description of Work to Be Done: 2Cr' <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO PF[ <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceAfy first I have road and examined this application and know the same to be true end <br />correct. All provlsl ns of laws and ordinances govemin this type of work will be completed <br />whether specified rbreln or not. The granting of a perm9f does not resume to give authority to <br />violate or cancel t1 a pprovlslons of any other state or local law regulating construction or the <br />performance of co stm at I am a zed r of this roperfy to perform the <br />work for whi;1 icaflon is me comp the ate Contrectors Lsw 18.27 RCW end <br />296.200 <br />G 17 j (-ZJe-6 `- <br />Signature Date / ob �' ) <br />