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� f <br /> j <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � ��-�-�� <br /> 3200 CEDAR STREET, EVERETT, WA98201 v;0707 -��b <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEP7ED <br /> 4fl97 R�n�rl�ygy <br /> PROJECTADDRESS <br /> .�uncore H�Iding lI LLC <br /> Owner Mail Address Ciry State2ip Phone <br /> ;o Ca c,a,:�r. 3027 Broa way Everett WA 98ZOI <br /> TenaN Mail Address City State2ip Phone <br /> ]nslpnia �ipn Inc PO BOX ?849 Renton WA 98056 425-917-2109 <br /> Eleclrica�Conlraclor Mail Address City State2p Phone <br /> KCIf_C1fl�SIC ��00 �� <br /> �"—"—��`--" Contract Price of Work <br /> Slate License Number <br /> � 76 Gas Station Steven Thomson <br /> Pr�posed Use uf Building Contact Person (Plan Review) <br /> Description of Work to Be Done: IIi�.-ii iicw ^a"j" 7C �'anaae t�ic�i�1(1 C�i -��il� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC ORAC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that!have read and examined fhi&application and know the same to be true and <br /> correcL All provisions ollaws and ordinances goveminQ this type o(work will be completed <br /> whether speafied herein or not The granting o(a permd does not presume to give autY,onty to <br /> violate or cancel Ihe provisions oI any other state or local law regulating consWction or the <br /> perlormance o!consWchon. Thaf I am authonzed by the owner o/this property to perform!he <br /> work lor which applrcation is made and 1 comply k�ifh the State Contractors Law 18.27 RCW and <br /> 29G.200 WAC. <br /> Sfeuerr, Jf��si�t�a�t ne t) 7/ 25 /07 <br /> Signature Date <br /> �c��G7- I ) G <br />