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t <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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />3Li Roth !�, S it S P <br />PROJECT ADDRESS <br />Owner Mad Address City StateiZtp Phone <br />jjei i �-nrrre`t", told)b Min l( PUCK 51 aOl, Jere + I- , Q�3 4 - 6 <br />Tenant Mail Address City staleizip Phone <br />Mail Address <br />N I I fit _ n-i-1 nukta -1 <br />State LcQs 114umblir <br />Proposed Use of Building <br />Description 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 />City State/Zip Phone <br />s, ibas <br />Contract Price of Work <br />Contact Person (Plan Review) <br />I Hereby certify that I have read and examined this application and know the same to be true and <br />cronecf. 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 previsions of any other state or local law regulating construction or the <br />performance of construction. That 1 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 />FEE <br />Mi 1 Lci 54A -06 `g-I <br />gnature Date <br />lX"� <br />