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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 08201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM G1 —I _3 <br />Nh <br />PROJECT ADDRESS <br />Owner Mail Address <br />L\1a, t Ir� <br />Tenant <br />City State/Zip Phone <br />I . fspc . <br />v-Q, 4 (AA `'IK3 9qY-3l^n <br />City State2lp Phone <br />Au, <br />Nw�-r duo LL �� 9s�ii YW1-0?// <br />Electrical Contractor Mail Address City State2lp Phone <br />&'UrV),v610V6'/L'IOo <br />State License Number Contract Price of Work <br />04( V11Q-0:krk SCVvvCt•, <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done f r- • c< &CQ r - 2I t <br />NOTE, WIRING IN NON -DWELLINGS IS REQUIRED TO FEE 1 <br />BE IN RACEWAYS, MC OR AC CABLE. 111 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 0105 <br />I hereby certify that I have 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 specirred herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the pprroovisions of any other state or local law regulating construction or the <br />pert of construction. That I am authorized by the owner of this pproperty to perform the <br />for w licafion Is made and I comply with the State Contractors Law 18.27 RCW and <br />6200 W <br />V 30 <br />%nature Date <br />PC�aR-CAq <br />