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1' <br />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 />t <br />OIL() Fl/EC?(,/eFjZA{ cJAV <br />PROJECT ADDRESS <br />Owner Mail Address City StateOp Phone <br />T�J&d7r yzs <br />EAGLE Cyst+ Ex Pt2ecC y'l l0 FUE1e6v_(57C.j r✓I}Y -r/ ./L - rf e✓& �Sv-n.r;r <br />Tenant Mail Address City -� Stale/zip y Phone <br />M 171<r ITEO <br />F�bVAtJLG0 Ej\;C%Z 4 5'E2u14Lr"<lr)c loSt4MulCv SPr=4 A,O to ulro rua- 4CS-s'LS� <br />Electrical Contractor Mai; Address City State/Zip Phone <br />A bIjPriESR5c,'i�5 � 2,000 <br />Slate License Number Contract Price of Work <br />ep I #IA Y Lo n n, s <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: i At S t"Ff L L 5 L[ P> - io R N E[ r C/ r2 c u r 7- 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 />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 not presume 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 1 am authorized by the owner or this roperty to perform the <br />for is I file State Contractors Law 18.27 <br />work which application made and comply with RCW and <br />296.200 WAC. <br />Signature Date <br />��-1 �� <br />