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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 /2.a6--/0 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />Owner Mall Address City State/Zip Phone <br />Tenant Mall Address City StaleOp Phone <br />���+,t✓�� Ztis�� ram, /3111�i 1/fe�j-rie/ fo/4763 /f/`1ag IdA" 011z 1� 1�340 <br />Electrical Contractor Mall Address City State/Zip Phone <br />/110'41c /w//t 3�-�41' <br />Stall _,�ense Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: /mac Nlg�riLQ tt 3 Uri �/j' G�J!^�rl��f✓���T44 J <br />l 144r r liGr4 <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 ' I Z I t 1 <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 pemut does not resume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or file <br />perfomiance of construction. That I am authorized by the owner of this roperfy to perform the <br />tvork for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />/Z, /5 /0 <br />Signature Date <br />