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i <br /> 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 - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> 14 7 G th in v'E. <br /> PROJECT ADDRESS <br /> TtfgAnne ANSI (K 14 76th f-t fE . Evejetl) ►Nf . qual y252�c-5� g <br /> Owner Mall Address City StalelZip Phone <br /> Tenant Mail Address City Stale/Zip Phone <br /> LAnder Eje(l ( fervi(e) L L[ II f59 Np 14 pellevueo Wh ggw5 <br /> Electrical Contractor Mail Addresi City Stale/Zip f *2 5-gdnPhf j j I <br /> LA rjDEF,,r9gIpCf 600. 00 <br /> Slate License Number Contract Price of Work <br /> tringle farnilu ei tr h r man <br /> Proposecif Use of Building 4 �lontact Per n (Plan Review) <br /> �/ <br /> Description of Work to Be Done: _ 'L O D M `f/I C/ /�/�1 '- ' e t` r <br /> NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO FEE <br /> BE IN RACEWAYS,MC OR AC CABLE. <br /> 7r,. OD <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> thereby certify that I have read and examined this application and know the same to be true and <br /> correct Ali provisions ollaws and ordinances governing this type of wotk will be completed <br /> whethoi spocdmd herein or and <br /> The granting of a permd does not presume to give authority to <br /> violate or cancel the provisions 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 /> for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 288.200 WAC. <br /> I� � Date <br />