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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES Perwtt+ # <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 /> _ 163 7jp4-A St . 5 Eyevettl WA - <br /> PROJECT ADDRESS <br /> 1 Amey *F 163 - 7(dA57-ScjiVevetf,0A.98263 'f25V3� 9 <br /> Owner Mall Address City Stalemp Phone <br /> Tenant Mall Address City State/Zip Phone <br /> DOACY' SAPAe <br /> Electrical Contractor Mall Address City StatelZip Phone <br /> Slate License Number Contract Price of Work <br /> AY A q <br /> Proposed Use of Buildind Contact Person (Plan Review) <br /> (� <br /> Description of Work to Be Done: 1�Dw e-Y +-D Y' A e - <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 road and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified heroin or not. The granting of a permit does notresume to give authority to <br /> violate or cancel the previsions of ally other state or local law regulating construction or the <br /> performance of conspmction. 11mat I am authorized by the owner of this property to perform fire <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW end D <br /> 290.200 WAC. / G <br /> - <br /> SignatureDale <br />