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ELECTRICAL PERMIT APPLICATION <br />CITY' OF EVERETT PERMIT SERVICES _Ia -or <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org 'Po g—f <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />\0tr� \off "A SH <br />PROJECT ADDRESS <br />4�o kav�e� Ws��.Ev�.a °1Ra�3 <br />(Tuner Mall Address City Slatemp Phone <br />Tenant Mail Address City staleop Phone <br />S w �In �QC3r ; C- P?�x 4-7S'CILIc4 u1s •jai guy <br />Electrical Contractor Mail Address City state2ip Phone <br />SNOAOGSklo? W <br />Slate License Number Contract Price of Work <br />Proposed Use of Buddng Contact Person (Plan Review) <br />Description of Work to Be Done: TQ" Cie ctx q S ,4. r V 1 <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. �� U <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify (hat I have read and examined this application and know the some to be true and <br />correct. All provisions of laws and ordinances goveminp this type of work will be completed <br />whether specified herein or not. The granting of a pgrm t does not resume to give authority to <br />violate or cancol the provisions of any other state or local law regulating construction or the <br />performonce of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law f 8.27 RC W end <br />296.200 WAC. <br />atur Dale <br />