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SH/28/20I I/',=D 12: ; FPI Seattle FAX No, 4252909600 F. 002 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8357 — www.everettwa.or0 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />G—/lo 5 <br />�-70- /4o4i Ave,ll.f <br />PROJECT ADDRESS <br />d-702 1/ 317-0� 1 <br />Owner ill it Address City State/Zip Phone <br />Tenant Mail Address City stale1ztp Phone <br />Electrical Conlracter Mail Address Dry State/Zip Phone <br />z C-17 OLltgL /, _00. r1)L2 <br />State License Number Contract Price of Work <br />Co1"11MC(( <br />,�"C,I1/ l\ob IJa+-..Q' <br />Proposed Use of Building / Contact Person ( Ian Review) <br />Description of Work to Be Done: L(C/ / ��`t'� �� G(elr�Gt � �O��d I'14yr, 4 JAtr'e _ <br />i S <br />NOTE: WIRING IN NON -DWELLINGS IS REOUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CIr' OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that / have read and examined this application and know file same to be true and <br />correct. All provisions of laws and ordinances gove.^ung this type of work will becompleted I <br />whether specified herein or. not. The granting of s penntt does not resume 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 compty with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />'15116 4111 <br />ignature Date <br />