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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />4=5-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />Owner Mail Address City Slalelzip Phone <br />C nest_ <br />Tenant Mad Address City SlalelZip Pho'". <br />Uas3l <br />3v,,,n ',NZ,Nr %:.. wG �B'S�� �oOb Ab <br />Electrical Contractor Mail Address City Slate17111 Phone <br />2, CM t1b <br />State License Number Contract Price of Work <br />c.s C <br />Prep')N Llse of tuddinq Contact Person (Plan Review) <br />Description of Work to Be Done e\tLNA-, Z' . S C�_r-s? L t��• L.ph <br />NOTE 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 3105 <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 specified herein or not The granting of a permit does not resume to give authority to <br />violate or cancel the previsions of any other state or local law regulating construction or the <br />performance of constn2Yion. That I am authorized by the owner of this pproperty to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18 27 RCW and <br />296200 WAC. / <br />� r�o��� <br />Signature pare <br />