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ra <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 />WO 80051 &itF &irefl 4203 <br />PROJECT ADDRESS <br />Owner <br />Mail Address CRY <br />State/ZipPhone <br />ME) Cxkripa <br />1K. 14?0 PK Si S► idEyerefi <br />10A q8?03 <br />425-216-15CO <br />Tenant <br />I Mail Address CRY <br />State/Zip <br />Phone <br />mp <br />t1C 0011f 'ym om6h <br />QUA. g89042616.bDo <br />Electrical Contractor <br />Mall Address City <br />State/Zip <br />Phone <br />Al- W M Sled <br />State License Number <br />MeVAN IIAP <br />Proposed Use of Building <br />Descriplinn of Work to Be Done: <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Flo] <br />I hereby certify that I have road and examined this application and know the some to be tore and <br />correct. All provisions of laws and ordinances govemmg this type of work will be completed <br />whether specified herein or not. The granting of s 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 />performance 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 Lew 18.27 RCW and <br />296.200 WAC. <br />FEE <br />41&& 64,,11,,,_ 101ojoq ,� - <br />Signature O <br />q� <br />