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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 — vnvvd.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />9S201 <br />Owner Mail Address Clly Slate/Zip Phone <br />Tenant Mail Address City Stale/Zip Phone <br />23Z(o /?! ST �iZ.s33o <br />crrt� /�l�� nitu�.�Hi1lr.+mS 14r.-i�:- C,,eee�2�s- a�3a <br />Electrical Contractor Mail Address City Slate/Zip Phone <br />S 6l,!!VDA �S ZJ _-�W R <br />Stale License Number Contract Price of Work <br />L"�'-f r11 r(_ kl rf <br />Proposed Use of Bwoding Contact <br />//Person (Plan Review) <br />Description of Work to Be Done: �/y�22-11 �2 ✓2it �6.l D3%^7� ��✓ <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 />1 hereby certify that I have read and examined this application and know the same to be true and Q <br />correct. All provisions of laws and ordinances governing this type of work will be completed IJ <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 tile <br />performance of construction. That I am authorized by the owner of this roperty to perform the <br />work for which application is made and I comply with file State Contractors Law 18.27 RCW and / <br />296.200 WAC,"__ —j <br />,SKjnalure ate <br />