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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, VVA 98201 <br />425-257-8810 - FAX 425-257-8857 - wwvr.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />five - <br />PROJECT ADDRES <br />'de- Fyn cr/ 01„lc 39,I)i A44ile E�l°reTT?4 M261 7 <br />Owner Mail Address CityStateOp Phone <br />415 <br />Tenant Mall Address City State/ZipPhone <br />l at�ro�5 �32� -12e 4-&&ems G,�/9 id'2as <br />Elaclrical Contractor Mall Address City State/Zip Phone <br />!Jo <br />'uctli� �M 5 9f ,�� � -- <br />Slate License Number Contract Price of Work <br />Cl/n!L <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: < /" r c <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 ceriily that 1 have read and exem(ned Ihls applicallon 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 revisions of any other state or local law regulating construction or the %j33 <br />performance of construction. That I am authorized by the owner of this property to perform the vv <br />work for which appligaH made and I comply with the Slate Contractors Law 18.27 RCW and Dn <br />296.200 <br />--signature / Date <br />