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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 — wwvd.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />'.�% U.'�-7 t.�'/�..L; tE-✓E-L t!l.i"l-I<-'C <br />PROJECT ADDRESS <br />< tzc- I c' �rl��I <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City Stale/Zlp Phone <br />1, c'Sc t�J� i%''L'`.c:P.. /J� LFidZ/­-% <br />Electrical Contractor Mail Address City SlateZp Phone <br />tP1 �!`--- I-,-"(7 <br />State License Number Contract Price of Work <br />r r:'j 1 (- <br />Proposed Use of Building Contact Person (Plan Review) <br />S <br />Description of Work to Be Done: 1=--Z i rr L C r-C3— <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 rr ff <br />I hereby certify that I have read and examined this application and know the same to be true and lam{ 9 Z /0 & <br />correct. All provisions of laws and ordinances goveming 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 Previsions of any other state or local law regulating construction or the <br />performance of construction. That I am authutized by the owner of this operty 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. <br />Signature Date <br />7(—. 1 <br />