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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 />1515 Z5t'`St S►1 Slwt� y00 1✓V"96?03 <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Phone <br />Af f 05iftb 1211 0140Id M LA„ 4 IU dKo _w_ ayi t id 4A 31 139 1426 5611. 41%A1 <br />Tenant Mail Address City Slate/Zip Phone <br />' t.ieArm A46 i d?.6-ii imi <br />Electrical Contractor Mail Address City State/Zip Phone <br />Aff?MN99-4-sio A8264• GL <br />State LILanse Number tn1 Contract Price of Work <br />Q,IOrKs�L Ai �/IJ.� i' iallgQ- t�fJ /lkiin AMU _ <br />Proposed a of Building Contact Peron (Pla Review) <br />Description of Work to Be Done. I &ta w ✓D IhA11 G "mau juY A koza <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE _Q <br />BE IN RACEWAYS, MC OR AC CABLE. c) W <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />1 hereby certify that I have read and examined this application and know the same to be true and I <br />correct All provisions of laws and ordinances governing this type of work will be completed ZO L4 — l <br />whether specified herein or not. The granting of a permit does not presume to give authonty to <br />violate or cancel the previsions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work <br />for WAC application is made and/ comply with the State Contractors Law 18.27 RCW and <br />Signature Dale <br />