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ELECTRI�AL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREFT, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> 111Rf1 SF Rverett M811 Way <br /> PROJECTADDRESS <br /> Pan American Inc 1020 SE Everett Mall Way Everett WA 98208 _ <br /> Owner Mail Address City StateRip Phone <br /> �hevran GaS Station 10?0 SE Everett Mall Wav F�P*arr WA 9R208 <br /> Tenant Mail Address City State/Zip Phone <br /> Ine[gnia Sion Inc PO BOX 2849 Renton WA 98Q56 425-9 i 7-2109 <br /> ElectriralContrector MailAddress City State/Zip Phone <br /> 1NS1GS[055JS 55�0 00 <br /> State License Number Ccntract Price of Work <br /> �nP�ron Gas Station Chrystine Harv�.v <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: unn4 ^�+�� �xtra MlleagE_sigllage �� pvistin�rirrnits <br /> NOTE: WIRING IN NO(V-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 ceRily that 1 have read and examined this application and know the same to be true and <br /> correct. Al/provisions ollaws and ordinances goveming this type o(wo�k will be complete�i <br /> whether speci�ed herein or noL The granting of a pemut does not presume to qive authonty to <br /> violate or cancel the provisions of any other�tate orlocal law regulating construcfion or the . , <br /> peAormance o/construcf�on. That 1 am authonzed by the owr,er o(this property to peAorm the , ,�/� �� -' <br /> wodc/or which app6cation is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. �— � <br /> /l -t l�/l_��-��=�1[J�-`�� 1 z��rJ'��7 <br /> �..��{'.7L���. <br /> Sign�tJre D� <br />