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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 — vnvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�3 Li �'� � o_rris�,AU7. Ey�ref+ <br />PROJECT ADDRESS <br />'T�Tna clomp-, IRa14'liar��t� <br />Owns Mail Address Clty ✓ StatalziP3�0(0753qWo <br />Tenant Mall Address Clty Stoterztp Pho <br />( 3bo') <br />Lu1�ee� ,se4- :) fox ���� YYl�afuSUtl(e lt�h q��7o b02y3.S <br />Electrical Contractor Mail Addross City State/zip Phone <br />G(�R�TL'Z99I C,S 500 <br />State License Number Conv5at Price of <br />Work. <br />e&uk (l1'mgy-)k0in _ <br />Proposed Use of Building contact Person (Plan Review) <br />Squs�o�ge (f residential new construction, remodel or addition) l �" <br />Description of Work to Be Done: \t,I i•f� S % 1 P��C I t t.Q <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 road and examined this application and know the same to be true and <br />correct. All provisions of laws end ordinances governing this typo of work will be completed <br />whether spocil7ad herein or not. The granting of a permit does not resume to give authority to <br />violate or canto! the pprevisions of any other state or local law regulating construction or the <br />porformaneo ofconstrueuonThat lam authorizedby the ovmerof this �roporty to perform the <br />work for which application is made and I comply w. ith the State Contractors Law 18.27 RCW and <br />296,200 WAC. <br />�ll /i.rth(/a i�yjliFh 1 I — —1 <br />SlOnature Cato <br />ZO 39dd 0Id10313 NIAbd9 9099SEV09E t�ZtOZ Z00Z/90/IL <br />