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� g <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 3��3y�7 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �0�03'-�J 5� <br /> 425-257-8810 - FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> ! 1 T04 Hwv QQ snuth= Everett _ <br /> PROJECT ADDRESS ' <br /> Dennis 5 Candice Matheson 13425 Puget Sound Blvd Edmonds. WA 98026 <br /> Owne� Mail Address City State/Zip Phone <br /> ��IGviL►l �a� Cl�f:nn 1 17f1Q N,.�y QQ Cn..f6 F.�nroff WA QR20Q <br /> Tenant Mail Address Ciry State2ip Phone <br /> sipnia S;p_nJic PO BOX 2849 Renton WA 98056 425-917-2109 <br /> EleCiriCal Conlractof Mail Address CiN Slate/Zip ?hone <br /> tastr.s�ns�)� S500 00 <br /> State License Number Conlract Price of Work <br /> Ghevron Gas Station Steven Tha san <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descriplion of Work to Be Done�, Hook � IIe�:' ^anop.y�ignS_S_(�) cidac �r r Fn �ig�t�np to <br /> ��Q nlnnl�ir�1 rilGLl�c <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUiRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CAEiLE. <br /> CITY OF EVERET.T LOCAL SALES TAX COUE IS 3105 <br /> I hereby certify that 1 have read and examined this application and know the same fo be true and <br /> correct. All provisions o(laws and ordinances governing fhis type of work will be completed <br /> whether specified herein or noL The granting o(a permd does not�resume to give authonty to <br /> vio/ate or cancel the provisions of any other state or local law regu/ating construction or the <br /> peAomance ol constructipn. 7hat 1 arn authorized by fhe owner o/this property fo perform the <br /> work(or w/�ich applicati q is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.20 Wi4C. l <br /> / <br /> ^��.. �^��-�M �n i i aa ios <br /> • Signature! I Dale <br /> ` J <br /> � U5��3 c�sl <br />