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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.everettwa.org L O1?OS-/6, <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />Owner QQ Mail Address rr City Slate/Zip .1 Phone <br />AvQ rife✓„F[ t1�11 <br />Tenant Mail Address City State/Zip Phone <br />IJCrhf, 5W Electric 005 5evfr, Jn.:kcon 5f. Seit&te wra. 9,g144 ;06-3;q-IS96 <br />Electrical Contractor Mail Address City statelzip Phone <br />J <br />korf4SE� 02 I,,ayy� _ <br />(In <br />Slate License Number L I1/ 5 ID Contract Price of Work <br />oil e 1/ c ./ iti Czcc) 7S3- 7f 76 <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: `f rj � � o� Or < <tl✓ r �- i� d' P c �l L t 3 �h oui�` f 5 Scat <br />a,Hft d 1-e/f-o P; i rev/ee <br />I ��hfi s <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 />- <br />1 hereby certify that ! i+ave road and examined this application and know the same to be true and L,0605 6q <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herem or not. The granting of a permit does not Presume to give authority to <br />violate or cancel the pprevisions or any other state or local law regulating construction or the <br />performance ofconsWction. That / am authorized by the owner of this property to perform the <br />work for wh"t application is made and 1 comply with the State ContractorsLaw 18.27 RCW and <br />296.200 WAC. <br />i <br />r <br />d s <br />Slgnaiere °j Date <br />r. <br />