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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.everetlwa org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />SCFF&LY & EW _S AvVtC. <br />Owner ,, '' ^^ Mall Address City State/Zip Phone <br />/VA- <br />Tenant Mail Address City State/Zip Phone <br />SQl LjTiox_.)s CLe2 RL T,ur ?oOolr17i�i F-,.1TY <br />s�'tz <br />Electrical Contractor Mail Address city State/Zip Phone <br />(_v7-E * � <br />State License Number Contrac Price of Work <br />Proposed Use of Building / r r Contact Person (Plan Review) <br />Description of Work to Be Done: �004L L ly,A L � E -2rw /fg,0 <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 this application and know (lie 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 perm]( does not presume to give authority to <br />vlolaty or cancel (he revisions of any other state or local law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this pproperly to perform the <br />work for which application is made and I comply with the State Confrartors Law 18.27 RCW and <br />296.200 AC. <br />Ignature U Z`J <br />