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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 3 —D <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org G�O103-4 2� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />jtloz �>G ✓c//.11 / to /l bt%ty G✓61e'e <br />PROJECT ADDRESS A <br />✓G�ri 7 r Ma � I — S6G X o✓e� NZS ass 1 '77 l <br />Owner Mail Address City F;iaiefzip Phone <br />�Ine 2 I - 5ve Above yZs-SN- 9969 <br />Tenant Mail Address City State/Zip Phone <br />AG6e551 / PI' 0,5LLC -1,U33 S9yf�✓cN6S1e.1IN ArJnyloN, lr fA ?9223 �%b-670- <br />Electrical Contractor Mail Address City State/Zip <br />AcLE551vL,�Zgo9 <br />State License Number Contract Price of Work <br />1z l KI - r:l< Ye? LAA <br />Proposed Use of Building Contact Person (Plan Review) <br />/' Iof iN <br />Description of Work to Be Done: � 5 nevi careP <br />t74 GI�INe, �"GX Ir N(�i <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE �I <br />BE IN RACEWAYS, MC OR AC CABLE. <br />i I ^ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that 1 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 permit does not resume to give authority to <br />violate or cancel the prowsions of any otherstate or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this pproperty to perform the <br />work for which application is made and/ comply with the State Contractors Law 18.27 RCWand <br />296.200 WAC. <br />Sll§nature Date <br />