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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.everellwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�565 ��k�c�eson Kcl _— <br />PROJECT ADDRESS <br />S�V1f �n�o[rx.%� iT 1280K SE `30r/L'rt�l / 1rn ,r-�G (��'12 <br />O[w'ner Mal Adddress2ry�� ,1y� r� ^rCitty ' 1� 1� 5nle/bp Phone <br />, I/ 111 t �,(T4 ll��'� �' !11 )Il rl S J' I�fLI"Slli l Y? G�p C(" 'L <br />Tenant Mail Address c,,q. -late/Zip Phone <br />� h�n�;nAlarin�c 2030 A�rau� 1,(aHS �� �i�s13y 206-37R-32��6 <br />Electrical Contractor Vj I Add,,, t. ty StahelZ,p Phone <br />State License Number Contract Price of Work <br />Proposed Use of Budding 2t[XArDContact Person tPlan Review) <br />I t1M-? (3i <br />5t�1�Ir r^� 8YS�, f�Unr° <br />Description of Work to Be Done Un j_]J CQ � Of C- r <br />Y <br />L rely t` )ro lli �s,s ��0 , Z Aew m,I)Q( ?0 fdns. <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS. MC OR AC CABLE. <br />135 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby codify that I have read and examined this application and know the same to be true and j <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />Irhethor specified herein or not. The granting of a permit does not ppresume to give chill ty to <br />violate or cancel the ppmvisions of any other state or local law regurating construction or the <br />performance of conslmction. That 1 am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />295.200 WAC. <br />0�04� <br />Signature <br />