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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 <br /> 1/ 7 - 7 914 P/Q Cx- -5F <br /> PROJECT ADDRESS <br /> Fy" Clo I VCt 5;A q' A�Nor; / 2715 l$ 1� Sf If- wA- 9 920 ( N25'-3o3-112 <br /> Owner Mall Address city Stale/Zip Phone <br /> Tenant Mall Address Cay Statelzp Phos <br /> 12N- F(e.1 r. , 571$ S, env((c.J 51 7QCOr.-w L4A 4P1lo9 255.31,6-2P00 <br /> Electrical Contractor Mall Address City State/Zip Phone <br /> �WEI.F _ " `l19' Fir <br /> State License Number Contract Price of Work <br /> RtSIarJ�iyl — Sr.d rM iI <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done N c J c o US I r v�>`r o.J ? 1 4 `l 542 PF S29 r.L <br /> q 3 Sa Fir A og,,. ;,r- <br /> NOTE: <br /> LNOTE: 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 3106 <br /> I hereby certify that I have read and oramined 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 cancol the pprovisions of any other stafe or local law regulating construction or the <br /> performance of consliuchon That I am authorized by the owner of this rly to perform the <br /> work for which application is made and I comply with the State Contra ors Law l8 27 RCW end <br /> 296.200 WAC. <br /> j%/ ` 5• Nav /rJ ow�cr b 3-�u /n Da� <br /> Signature to <br />