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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 1515 LOMBARD AVE <br /> PROJECT ADDRESS <br /> SUE RAY 1515 LOMBARD AVE Everett WA 98201 425-350-4592 <br /> Owner Mail Address City SlateJZip Phone <br /> Tenant Mail Address Ciry StatelZip Phone <br /> WESCO 3909 196th St SW, Lynnwood WA 98036 800-398-4663 <br /> Electrical Contractor Maii Address City State2ip Phone <br /> WASHIES9710D ex 09/02/13 $600 <br /> State License Number Contract Price of Work <br /> SFR <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done� <br /> Heat pump install <br /> NOTE. WIRING IN fJON-DWELLIf�1GS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i <br /> I hereby certily thaf I have read and ea�amined this application and know the same to be true antl <br /> carecL All provisions of/aws and ordinances govern�ng th�s rype olwork�vill be completed <br /> �vhe�her specified herein or noG The granting ol a permit does not resume to give auihortty to <br /> violate or cancel the provisions o/any otiier state or local la�v reguPting construci�on o�the <br /> per(ormance ot consiruction. That/am authorizetl by fhe otvn�=r o/this properry to perlorm the <br /> �va�h!or n�hich application is made antl I compty�vith ihe State Contractors Law 18.27 RCW antl <br /> 296200 WAC. <br /> I)iyitally�iyn�,tl 6Y lenni(ai 13wycss <br /> J e n n i f e r B u r g �s s � �� -� '�� �L " � "noim+w�srrr�nair. <br /> aa=N OflTI i iVCST fCR11R.email-li•^��ifci 5•���vp.v milmm.c=US /� <br /> ,�Lr���.mnrc �� o��li'�lll) <br /> Signature ate <br />