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• I <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 /> 5 / Z ( rniY t(, t S� <br /> PROJECT ADDRESS <br /> T2s- 232-34-� <br /> 3 JS 4A- J+ SAS„ L,. 7/L i,il S l a« S3120 u A t✓1L lte, LA- 9g 2 71- <br /> Owner Mail Address City State/Zip Phone <br /> Ten,2(nt Mail Address City State/Zip Phone <br /> /4_ <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number Contract Price of Work <br /> SUSCt.'� <br /> (-LJ "CC <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: !1)LAce X I S T. w 6- o1!6 /. l5 -f- 5 !( eES /MJv/-- <br /> .tX J P-65/ C'ki,ki.J(re L,7 2I4 3UjtLb Zn 070'ZL -7� ft2 HeA-7 -� <br /> T_e'Pi,A—c- t✓AN-Ads I FAA s <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 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 thisroperty to perform the <br /> work for which application is made and!comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> j' it <br /> .�) � ' - Sic2 /6 <br /> ature Date l ! <br />