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Oct 29 16 12:16a Bob Jack 196746777 p.1 <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 /> �a D - <0eif^ <br /> PROJECT ADDRESS <br /> Owner Mail Address <br /> City Sate/Zip �fP ho <br /> Tenant Mail Address City ' <br /> State/Zi p Phone <br /> Electrical Contractorit Address A <br /> City StatefZip Phone <br /> 0 y f9rs� . — <br /> en _ <br /> State License Number Contract Price of Work ^ <br /> �1"41 A'j f�v�X�rf I vac 3 Sq la <br /> Proposed Use 6f Building Contact Person (Plan Review) <br /> Description of Work to Be Done: <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CEN OF EVERETT LOCAL SALES TAX CODE 1S 3105 <br /> 1 hr <br /> ereby certify that t have read and examined this application and know the same to be true and (- 1 f ( /�y L 0 <br /> /� <br /> correct. All provisions d ordinances goveming this type of work will be completed l� ` V ` l i <br /> whether of specified here er not he granting of permit does not presume to give authority to <br /> violate or cancel the visions o any other state or local law regulating construction or the <br /> performance of cons ction. Th J am authorized by the owner of this property to perform the <br /> work for which appli [ion is mad an l comply with the State Contractors Law 18.27 RCW and <br /> 296.2Q0 WAC. <br /> Signature <br /> Date <br />