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Oct 24 14 02:50p Susanne Olson-Homework & <br />�. 8 0� L <br />PROJECT ADDRESS <br />�Tnf �� <br />Owner <br />Tenant <br />360-794-5031 p.1 <br />� �GG 10�.�� I�. <br />t,.�1�-n. t 3� <br />ELECTRICAL PERMIT APPLICATlO <br />GITY OF EVERETT F�ERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-88� Q- F,4X 425-257-$857 - www.everettwa.org <br />APPLICATfONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�� � <br />Mail Address <br />Mail Address <br />��f �' . 130/� <br />EleCtriCal ContractDr PAail A.ddress <br />d�.'A�-c..L - O � � �'✓1 <br />State L'icense Number <br />Proposed tJse of Building <br />oescription of Work to ae Dan ��`'P�+^���- <br />,� �'�'cl� � 1�1� lpcxo4 <br />I <br />� 1'.Q�✓� d/+� 1_� <br />� r.JA . ���J <br />Sa,K,e �itS A,Be �-� <br />C i ty S tate/T p <br />Gity StateiZip <br />'�%� f�f'1D/+�I�'2 �J/9. c <br />City 5tate/Zip <br />� CA� <br />c <br />NOTE: WIRlNG IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />� 777� �o <br />Gontract Price of Work <br />w '�� ,i 1 1 <br />Contact Person tPlan Review <br />�'.�c,Z�_32D -�C,�. , <br />�b ���NQ- ,$� o <br />-��. _ f .--rL �. • /1 /' <br />FEE <br />��-� l3. <br />�l��D-l�a <br />CITY OF EVEitETT LOCAL SALES TAX CO�E IS 31 D5 � <br />1 hereby cerfify that ! have read and examrned fh;s applicafion and know fhe sarne to be frue and ��� g� <br />correct. All provisions of fa�vs and ordinances g�oveming tf�is type of work will be compiefed �o <br />whether spec�fred hersin or noi. The qranting of a permrt does not presume to give aufhority io <br />violafe or cance! fhe rovisions of any ofher state or local !aw regu7afing consfructr�n or the <br />perfnrmance of cons�rucfion. That 1 am authorized by the owner of tf�is properfy to perform fhe <br />warfc for which applicafion is made and I comply with fhe State Confractors Law �18.27 RCW and <br />296.20� WAC. <br />�/� <br />Phone <br />Phone <br />Phone <br />