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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 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />Owner Mail Address Clly StateOJp Phone <br />/ t��s- 3sf v� Y . <br />%ice ��u f��r18 /r S � O� Urr' /ter.-i, l�/g•> Ce41 `9?ea �b � - W-617n <br />Tenant Mail Address ty Stale?Jp Phone <br />2 EL c> <br />Electrical Contractor Mail Address City Siate/Zip Phone <br />4;n n/2/j_RA too <br />Slate License Number ' Contract Price of Work <br />Proposed Use of Building Contact Person/ (Plan Review) <br />Description of Work to Be Done: re%jil�� �tier Stoil �ge/OCCde- %t)-tel� of /CC41 <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 />1 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 goveming this type of work will be completed <br />wlmeflmer speclRed herein or not The granting of a pennd does not resume to give authority to <br />violate or cancel the previsions of any other state or local law regulating construction or Ilia <br />performance of construction. That I am authorized by the owner of this roperty to perform the <br />work for which application Is made and/ co ply with Ilia State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />7-;3•- 0 <br />Sig lure L Date <br />f;Fi <br />