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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I �13 <br /> 425-257-8810 - FAX 425-257-8857 —www.evereRwa.org <br /> �3o <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM , <br /> 1 32 1 Cot i AJF. <br /> PROJECT ADDRESS <br /> j 1VtDENCE IIIED CTL. PQRrve 67.3 ScA1Tc.E WA ` 138* v75-2o =.S/2 <br /> Owner t.ta•i AdCress Cs State!Zo Fr..cne <br /> Tenart 1.13!:stress Cary StateZp Pncne <br /> 1505 LuEs-rt.A,c.e Ave. N, STE 520 X 704/ <br /> AR-06-3506JSRICA) i,y GalvP 14(6 5i me LuA %$IOC' 204y•2SY-3553 <br /> Electrical Contractor !.13 I Advess Cray StateLe Phone <br /> AkoMssG o 19 - 4 <br /> State License Number Contract Price of Work <br /> Proposed Use of Budding Contact Person (Plan Review) <br /> Desccrhipeon of Work to 8e Done• IN STALL LOOw UOC r 4( c SEC - 'T 7 SY STEX - d - )783, <br /> l_ E <br /> O l>v AA-PUS - '5TN PLOO/?, trlEQlrrtiE lk <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 /> I herebycertify that I have read and examined this application and know the same to bo true and E1302, - 0 Gs <br /> correct Al!provisions of laws and ordinances governing this type of work will be comp!eled <br /> whether specified heroin or not The granting of a permit does not presume to give authority to <br /> violate or cancel the provisions of any other slate or local law regulating construction or tho <br /> performance of construction That I am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18 27 RCW and <br /> 29r3o WAC. <br /> �- 2 -11 - 13 <br /> Signature Date <br /> PAUL. ARCNSc,u@ Aeon Lox,Sat CvPITy. CoM <br />