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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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />Messier- �Ju9alhl <br />PROJECT ADDRESS <br />Vicflitiif Sit II 5, O ailQ�de srWA 9�Zz3 6370 SU9 <br />Owne Mail Address Ci y State/Zip Phone <br />�essier 6usatr; 7s05 Hadefiso ., rert°trou 9Fir zo3-Gz73 'oaa-" 6 <br />Tenant Mail Address City Stale/Zip Phone <br />zelp6- ��wnu�icstio�s ,K. 32n7 I''Ave-s. See rfe, WA. 9813' Z86 z87-418I <br />Electri al nlrac:or Mail Address City r State/bp Phone <br />zEPuY('ronol_N — <br />State License Number Contract Pnce of Work <br />Mw'ftratian Ew;pvteNt feTiVo <br />r u Ni»4arj <br />Proposed 'Jse of Building �- Contact Person (Plan Review) <br />Description of Work to Be Done. 1nSt211yet6e Q Alfa C&, )e iN r25truct0re. <br />NOTE. WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. 3S o_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that 1 have read and examined this application and know file some to be tme and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whelher specified herein or not. The granting of a permit does not presume fo give authonty to <br />violate or camel the pprovisions of any other state or local law regulating construction or flee <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 Stale Contractors Law 18.27 RCW and <br />296.200 WAC. <br />13 TvAe ZO <br />Signalur Dale <br />Cly� E�ererr BusiHPss �iCC�Sr: �i rl-Zti SF! ��7 _ �� <br />