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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 `a() — <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROJECT ADDRESS fjEffy7. _ tf✓ <br /> Co.a 1 3OU� 4����L�f i L A'dt E -evq. ���► C')dol <br /> Owner Mail Address City Slate/Zip Phone <br /> Tenant Mall Address City State/Zip Phone <br /> 1 oL 41le,• tet kA-c- SR'��,r�, t"IOD\kE3, wq 9g`�.g�1 3too <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number Contract Price of Work <br /> • J°-eL VS L1ZS. 3`(U I.15 <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: SO\air t r> k\ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> RE 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 riot. The granting of a permit does notresume to give authority to <br /> violate or cancel the rovisions of any other state or local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this properly 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. /Ob (-) <br /> V <br /> Sig lure Date <br />