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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 /> 30 Was7` f4Ai,1 *9' V, L4/ Dri <br /> PROJECT ADDRESS Lf,lc-30(1-6w <br /> &'I4oka Ge4 Sai,(a a "bilivay � ado Pod Sig. /_vehto I (,✓11 gvow1 <br /> Owner Mail Address / City State/Zip Phone <br /> Tenant Mail Address ( City State/Zip Phone <br /> t di itg!on o��s��5aK{a F8 Raf I, <br /> Electrical Cdntractor Mail Address City State/Zip Phone <br /> f/3 00 <br /> State License Number4,41A1110\__ <br /> Contract Price of Work <br /> gadltd <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work o Be Done: RO((JCQ ro for _ ( t o utas 4l014,4 cat- l /0 6) <br /> b L1/ <br /> y 1 , <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not resume to give authority to <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. Th-t I am authorized by the owner of this property to perform the <br /> work for which application is m-:- and I comply with the State Contractors Law 18.27 RCW and <br /> 296. 0 WAC. <br /> 7 , <br /> . GQ_ A <br /> Signatur Da (jo t <br /> / °i <br />