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1 <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 S AM TO 4 PM - <br />C-1z03--039 <br />406 -:,Z ar--r7- MA&L WJV St LLA <br />PROJECT ADDRESS <br />7�4 LLc 75r_5 SL 6rSr5;MUCM ►si&,,16 I."9ROW <br />Owner Mail Address City SlaleZp Phone <br />A)w !l a ;4(PTO SauyicF Gnb r:yMX7-rA4W W" • - <br />Tenant Mail Address City StateZp Phone <br />" t► r F� r C'n�r��uc rcro� ��Qi'Ts�,p�Px�v We-9�OsT 4Z �— 9 <br />'-'-I-t State2i 'hone <br />Electrical Contractor Qp /� Mail Address City +J�P/�� /� <br />k th il�jlt'�.� C00, on <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: <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 J l/ <br />I hereby certify that 1 have read and examined this application and know the same to be true and r I Z� <br />correct. All provisions of laws and ordinances gcveming this type of work will be completed L 3— 02 <br />whather specified herein ornot. 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 authorizedby 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 />Date <br />Signature <br />