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I.1% (?1`7 `A..1 7-7) <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FP.X 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />4112 v Rucker Avg <br />PROJECT ADDRESS <br />SAC'- L4 <br />Owner Mail Address City State/Zip Phone <br />U Ia ib KL,it y...C1C, Evt_lez-r"T WA q `c3 1 <br />Tenant Mail Address City Slate/Zip Phone <br />V UA G-LE-G-re-I t_ 5C.0I H _T" AV, s SeA--'rtE w A 9 t31 O 0 7 <br />Electrical Contractor Mail Address City State/Zip Phone <br />V&LAeG-51I2-MV <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: 2ELD-1 E r_t,R-L.LLYTS A1K)b Wh1 V O l—ElAh t <br />VS�e_ pyl f <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 />1 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 presume to give authority to <br />violate or cancel the provisions of any other state or local IaN regulating construction or the <br />performance of censtruchon. That/ am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.290 WAC. <br />1 <br />Sign tur Dale <br />