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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 — vwvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM 65701 <br />PROJECT ADDRESS <br />/y%� 9L�ST�Cl[C /�6/� h��rU✓L' S� Snail is� 4 A ")PI W-5-765-Is <br />Owner <br />Mail Address City Stateup Phone <br />�y <br />lifts llliir /6 if Z5 20-/5ft <br />Tenant Mall Address City State/Zip Phone <br />�m r loyl c �c I�ng(I/7�°1 /i�cfnnr^� lyP4 �dn -Aq S <br />Electrical Contractor Maail Address City Stsstd2zip Phone <br />Contract Price of Work <br />State License Number <br />Pro sad Use o ullding Contact Person (Plan Review) <br />Description of Work to Be Done a L� <br />NOTE: WIRING IN NON -DWELLINGS IS REOU: —) 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 have read and examined this application and know the some to be We and �' �1 I — <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 regu aling construction or the <br />perfomiance of construction That I am authorized by the owner of this prcparty b perform the <br />work for which application is made and I comply with the State Contractors Law 6.27 RCW and <br />296.200 WAC. <br />r <br />g re Dale <br />