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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 PM E IZ03-13R <br />PROJECT ADDRESS <br />I 0 C F.LJZf &.:& PI&A u kA itz <br />Owner Mail Address City II I, Sta1 ip Phone <br />7_. _ zs) / <br />Tenant Mail Address City //yy S e/zip Phone <br />�rl rNti/FQS LLC 2 6 `I c Ss *1A 172 <br />Electrical Contractor Mail Address City State/Zip / Phone <br />706- s 3 <br />Ct1rij <br />Slate License Number Contract Price of Work <br />Proposed Use of Building / Contact Person (Plan) <br />� O Review) <br />Description of Work to Be Done: tX 1}�S(C f t n �Z7 � ✓6 <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, NIC OR AC CABLE. 50 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 p <br />1 hereby certify that 1 have read and examined this application and know the same to be true and E 12 03 —13 O <br />correct. All provisions of laws and ordinances govemmg 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 provisions of any other state or local law regulafing construction or the <br />perfomtance of construction. That 1 am authotized by the owner of this property to perform the <br />work for which application is mado and 1 comply with the State Contractors Law 18.27 RC W and <br />296.200 WAC. <br />Sig ature Dale <br />