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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 — vmw.everettvva.org <br />�1111 --16� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />067kr\ <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City Stale/Zip Phone <br />y2 <br />Li P)Penr- 4ec-tiri c 32� (OLL51 Sc- E f rf-r-t (v1� qJ- 9 Sf?0 ZS' <br />Electrical Contractor Mall Address City Slate/Zip Phone <br />Li rlea>° ( 903 13rJ 6 OU - <br />State License Number Contract Price of Work <br />fr) i( <br />Proposed Use of Building / Contact Person (Plan Review) <br />Description of Work to Be Done: 1.AJr 1"tf 'i(U t'— — <br />V C1 Vet ot, C L.G ✓1 V IC ✓1 I P c1 t —2 O �^�t �t"� <br />NOTE. WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACE'A'AYS, 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 file provisions of any other state or local law regulating construction or the <br />performance of construction. That lam authorized by the owner of this roperty to petfomt life <br />work for which appllc Lion is made and 1 comply with the State Con(ractors Law 18.27 RCW and I <br />296.200 WAC. j <br />Signal-. Dale <br />