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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 L�p�ps X75 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> /-/ 7 91/1 .5,Z_ <br /> PROJECT ADDRESS <br /> 1/ac" W Cl/9 9g2r" 3 '/Z 35 <br /> Owner Mall Address City State0p Phone 23 <br /> Tenant Mall Address city State/Zip Phone <br /> S57 45 Y .SPit/1..r e, -r/'5` '4cc�4 lo" /C i9 'IYZO <br /> Electrical Contractor Mau Address City StateZp o�•-- <br /> z ""z AN'7 5 /HZ L /dC,O'= <br /> State License Number Contract Pticee off Work <br /> T r'5 <br /> / z---, <br /> r,/ 4e'.1? 15 <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: i .. <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 /> I hereby certify that I hove read 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 herein or not. The granting of a permit 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 /> por'cnnance 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 18.27 RCW and <br /> 296.200 WAC. / <br /> -5—/7' �' J <br /> Signature Date <br />