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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 / - N-13 <br />425-257-8810 - FAX 425.257-8857 - www.evereltwa.org 130� 63 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Uq 1A5PS 7urkr it — <br />PROJECT ADDRESS 9, <br />C M J A to 1, 1 rfl YI S I /19/j & rjes/n, 911'---- <br />Owner Mail Address City State/Zip Phone <br />Tenant Mad Address City State/Zip ( ?'r /,Uhone <br />�rlc PktM 9� I_ Wet �yW .F <br />Electrical Con factor Mail Address City State2ip Phone <br />U4L(-r „t_ /H1 iv✓f Zgoo <br />State License Number q Contract <br />�"Price o/�f Work <br />1 P if, 0 ll[ A'I rAiq M L, _ SCI Oii' yr YT X <br />Proposed Use of Building Contac_ t Pprs�n lan�2evle <br />Description of Work to Be Done: 1 VC-'nf4 A 41L '04 p Y)1 <br />I19O r t I «%P01 to %,'�1d <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 910S <br />I hereby certify that I have read and examined this application and know the same to be true and I O <br />correct. All provisions of laws and ordinances govemrng this type of work will be completed <br />whether specified herein or not The granting of a permit does not resume to give authority to <br />violate or cantor the revisions of any other state or local law regulating r onsfrucl on or the <br />peAormance of Iron. That I am authorized by the owner of this property fn perform the <br />work for whi p rcahon is made and I comply with the Stale Contractors Law 18.27 RCW and <br />/ v ;=� <br />Signature ate <br />