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Jan 14 14 07 53a Vickie 0 <br />3606914838 p 1 <br />0 <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 — wmil.everettNa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />I <br />iPROJECT ADDRESS <br />Owner 6faii Address City State/Zip / Pnone <br />_7' Day Adyejj-h s f 3 V 3 'E� <br />Tenant Mail AEdmss City State/Zip Pnone <br />P ls��o e -e-jek TNc ?C�t Sy'K G�;rJ;�E mcs, cJlA- <br />Electrical Contracicr Mail Address City StateZp Phore <br />01 E=laroA-) 1,500 <br />State License <br />. Number (1 Contract Price of Work <br />i l � i'�-QA_aa -- <br />Proposed Use of auitding Contact Person (Plan Review) <br />Description of Work to Be Done: ✓i-e-iw` r✓�yz/J7LeiL Uf'/'&"� <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. 5O <br />57 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ---7ff <br />1 hereby certify that I have read and examined this application and know the same to be true and U 1 I <br />correct. All provisions of laws and ordinances governing thls type of work will be completed `� l I <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the previsions of eny othor state or Iota! law regulating construction or the <br />peAormance of construction. That I am authonzed by the owner ofCus property to perform live <br />work for which a hcation is made and l comply with the State Contractors Law 16.27 RCW and <br />296.20f WAC <br />A <br />signature � Da;c <br />vas 8 2-77 y <br />// <br />-- ! / C���/x�1ic Gf�ci ,'Its 9-�J <br />