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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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />_a_�._�o i EQ (_ 670E <br />PROJECT ADDRESS <br />E V E OETT S+-i i?"R D <br />Owner /��/� Mall Address City State/Zip Phone <br />A S -r 7E <br />Tenant Mail Address City State/Zip Phone <br />DUTTOM FIE R\C CO.�.YN,/UU�[X�OltllfiQSas�- <br />Electrical Contractor Mail Address City State/Zip Phone o0 <br />'D 19 SSao . oc, _ <br />State License Number Contract Price of Work <br />COY/) M -: C( A_ - a)AAJJE rY-F AILIo i_,W <br />Proposed Use of Building Contact Person (Plan Review) <br />/ <br />Description of Work to Be Done: (p00 Rr (yV2 S ERy L C_C� <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. u 5' <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 oflaws and ordinances governing this type of work will be completed <br />whether specified herein or i, at. The granting of a permit does not presume to give authority to <br />violate crcancel the provisions of any other state or local law regulating construction or the <br />perfoi7nance of construction. That I am authorized by the owner of this property to perform the <br />work far which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.20,7 WAC. <br />Sign ur Date <br />FD.5pq_ogc, <br />