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f <br /> ELE�CTRICAL. PERMIT APPL..SCATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.ory �� v�Z'� � <br /> ��g r� -o�t� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 6200 - 23rd Drive West <br /> PROJECT ADDRESS <br /> Seaway Lot 4A LLC 4932 NE 97th Seattle WA. 98155 J6-310-5239 <br /> Owner Mai�F..Idress Cily °:�.af_; Phone <br /> Teague 2727 Western Ave. N200 Seattle WA. 98121 206-838-4200 <br /> Tenanl Mail Address City State2ip Phone <br /> q � 3.c.��,5-3��-3<; o. <br /> /_=ii'c G.iCpe��cc7/tic ���uX i:`I7 fiT!t>n,(,-�z��J ��'2 r�f"<2, �'l�s J'7�.'(ci�Y <br /> Electricai Conlractor Maii nddress Ciry S�ate/ziF Phone <br /> Eu�t`-!.3 i (i 7 7�GO,v^O <br /> State License Number Contract Price of Work <br /> �:�/��/?^[?c"w..,',� /GiTGiR•'�.� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion af Work lo Be Done: �.=�=�'<=� �/�n-�'c[ T i-��� �c'i T/_?1r�'J PuT 9:.L�C'�. C�Nc /VC?�J <br /> �'�i:.�J�ii/i �'C�_ /::M/nP.��Y_'�G +�/��C�yUCL,�'�<�— <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 �� l I _ ��� <br /> I hereby certily that I have read and exsmined fhis application and know the same to be Irue and <br /> correcL AIf provisions ollaws and ordinances governing this type o�work will be completed <br /> whefher speci6ed herein or noL rhe granlin�o/a pennif does not�resume to give aufhonty to <br /> violafe or cancel the provisions of any other state or local law regulating construction or the <br /> pe�fomiance ol consVuchon. Thaf 1 am aulhorized by the owner oRhis propeRy to perlorm fhe <br /> work for�vhich epplication is made and 1 cornpty with Ihe Stafe Contractors Law 18.27 RC W and <br /> 296.200 WAC. � <br /> � <br /> � <br /> i <br /> ,_./_ , y/_�� .C�V ��f��v(�� <br /> Signatore Date <br /> � <br />