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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES ogo y _�33 <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.evereltwa.org y _ 9 01 <br />APPLICATIONS ARei ACCEPTED FROM 8 AM TO 4 PM <br />9bocl 16EL/nw <br />PROJECT ADDRESS <br />4d5 - <br />DoLe 7:?K6WJ inv>'l�-r DR is - <br />Owner Mel Address City State2,u Phme <br />n C <br />Tenant Mall Address City Sate,Lp Phone <br />CoeomuL 40 wPLL 6 vLvud &d1A1 n IN k4 C940?1() ?"h6A <br />Electrical Contractor %tail Address Cry State2lp Phona <br />CORRZET_ 92A 7 4a� . UD <br />State License Numbe• Contract Pnoe of Work <br />Proposed Use of Building r� Contact Person (Plan Rewewi <br />Description of Work to Be Done: /N_i TP Ue NI Co3�og/� ZP a!ZO{COL 7- <br />NOTE' WIRING IN NON -DWELLINGS IS REQUIRED TU FEE <br />DE IN RACEWAYS, A1C OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br />i <br />I hemby certify that I have read and exorre'nad this application and know the same to be true and L C./ /l <br />comecf. All provisions of laws and ordinarrcps governing this type of work will be completed `� I l� - v 3 > <br />whether specified herein or rat. The granting old permit does not pprreesum@ to give authonty to <br />violate or cancel th@ provisions of any other state or local low regufafrpg construction or the <br />pedomranco of construction. That I am authorized by the owner of this pproperly to perfomr the <br />work for which applrcaticn is made and 1 comply with the State Contractors Law 18 27 RCW and <br />296.200 WAC. <br />yG'--09 <br />Signature ---� Date <br />Z d 0918Z9909£ Oul Olfpe13 JopiffOC d99 l0 60 60 AV <br />