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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org p z-O9 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM COGJb q'o"1� <br />Z 10 Sw <br />��PjjROJECT ADDRESS p A <br />►ectrSon 1022 Aut-or; AVe �hVW 11'1ne to1A %8/33 <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City Slate/Zip Phone <br />Grvenwc�o {'�11n�M ���c. lab 66-.3072113 Sect& LO '03-725-77%7 <br />Electrical Contractor j Mail Ad ress / City State0p Phone <br />G9EE:N £c (32CLd / ����'� �85y <br />State License Number / Contract Price of Work <br />miu t\�AL Snf -s Jew- 0anlc �S <br />Proposed Use of Building Contact Person (Plan Review) <br />�NS aL%LL jWD QGZ l T% D! t— —�Ll fh <br />Description of Work to Be Done: <br />Sim n�9";Idi�71 <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have reed and examined this application and know the same to be true and - c Ulf- GL(c <br />correct. All provisions of laws and ordinances governing this type of work will becompleted <br />whether speci6ra herein or not. The granting of a permitGoes not resume to give authority to <br />violate or cancel Me provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this mperty to perform the <br />work for which application is made and I comply with the State Contractors L9w 18.27 RCW and <br />296.200 WAC. <br />c� <br />Signature Date <br />