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i <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 1 a f✓ -/0 <br />Eio 1 Z-o �7 <br />.300 3 w c l4. 5 L nro R. D� Ve�e ii w� 4 8 ZW <br />PROJECT ADDRESS Quifdi-N.. -10-0`I <br />QQ cuLuw.�r flat. ' Ott-�rt•5 <br />J1�� 11 IQ 30o I cn s,n.0 rj Ir.vere TT IVF, 48 zoEj <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor S9 Mail Address L City Slate/Zip Phone <br />L�c�IM/GcC <br />Contract Price of Work <br />Stale License Number <br />-TN$aN 510f4-NL. t016-353-YOV <br />Proposed Use of Budding "Contact Person (Plan Review) <br />Description of Work to Be Done. Nook urn c059*t se. 6eN�V 51rc3 c �-� 5 �*^"`'�'�='✓� <br />Ta MAc L62F, <br />NOTE. WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. 175. <br />%5r Q C' <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br />I hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to givo authority fo <br />violate or cancel the provisions of any other state or local law rogu/ating construction or the <br />performance of construction. That I am authorized by the owner of this roperty to perform the <br />work for which application is made a I co with rho State Contractors Law 18.27 RCW and <br />296.200 WAC. -� <br />Signature Dale <br />