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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.eveiettvva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />PROJECT ADDRESS <br />O.+ner MailAddresS City Stale2mp Phone <br />t21U<SC� h 1y e Y1 i'RA2c, quo <br />Tenant Mall Address City Staleop J!�u4hoge 1 <br />��raerxn� SUSlUnS tnc, Ci43 t S' Cc <br />Electrical Contractor Mail Address City ZOCc ' z -&twzi S � 5 10�e%3 r <br />��u�r 5�331�5 L-ne <br />State License Number ContraC Price of Work <br />n r <br />Proposed Use of Building c� .lJ ► )h� `1 �C/onlac Person (Plan Review) <br />Description of Work to Be Done: �l.WI 4 L' — <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 kno.v the same to be true and <br />correct. All provisions of laws and ordinances governing this We of work will be completed <br />whether specified herein or not. The granting of a permit does not resume 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- hick5appilion isade and I comply with the State Contractors Law 18.27 RCW and <br />296.J <br />S naNre Date <br />I <br />