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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />3US 5g- nle e'tl; Aj� I� <br />PROJECT ADDRESS <br />Gteentfee. IZ411 Ve.ntLLea. 81%)l. Studio `ileo4 <br />Owner Mail Address City State/Zip Phone <br />Q�k Amehr-a ' <br />30S 56 &)etet;G pl1r,_II Waj,� Euecett WA <br />Tenant Mail Address city State/Zip Phone <br />Vancouver Sign 6615 NE HWY 99 Vancouver WA 98665 3606934773 _ <br />Electrical Contractor Mail Address city State/Zip Phone <br />VANLOS 14_TC Q 3600 <br />State License Number Contract Price of Work <br />Goinvnerc%o Ap,,J, 5torm <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: ) I wm; &_7 --t e 5t�a r <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 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 a permit does not presume to give authority to <br />violate or cancel the previsions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 48.27 RCW and <br />296.20000 WAC. <br />/OR <br />SignatDate <br />_ <br />'� qV5 - <br />