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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 /> C 311 2 � A <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Q)( (A-14 crc� nom. X311 36 ue w tg 4� 0 Rv'e'� At- � 19 <br /> Tenant Mail Address 16ity State/Zip Phone <br /> -Pra_Coeln .� c_ 3v1�-( Hcyi- 6-ye,-crf , vuh qUo 7 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> _!�F_A CC)L_jjC 1.L-I DCS 61kLSC{ .sem_ C')s 355 - oa;-C' <br /> _ate License Number Contract Price of Work <br /> 6EN�.e -G­ct_ 1 OyJ C U✓�t 1 <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: C6c.&twA � � !l t 6C✓^ 1��� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. V f <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 governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does notresume to give authority to <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That I 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 /> Signature Date <br />