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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 L , 00(j <br />/� �1APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - -- <br />3 IZ � K uG��CI'- i7l/� <br />Mi <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Phone <br />Xw-� -Cr Ale t✓P �C.iif ���?a; M" <br />Tenant Mail Address City State/Zip Phone <br />,^( ivl&'r&nf<< % y �/l✓ 3302� �o <br />23,76 - /z/S'/i�e � L,:FL cr3�5 w/� 9P%Sam <br />Electrical Contractor Mail Address City State2lp Phone <br />---f� fro <br />,56 a N�ltiy � j ��� _ <br />Slate License Number Contract Price of Work <br />�lZS 3�a2t•�G <br />Proposed Use of Building Contact Person (Plan Review) <br />r- <br />Description of Work to Be Done: /y,`G 6,/4L <br />AFL Norio <br />, <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 />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 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 consfaxliea-Shot I am authorized by the owner of this property to perform the <br />work for whic cation is de and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 <br />Signature Dale <br />