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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—wuvw.evereriwa.org <br /> (,�..lS-1� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM y' 3 � <br /> (�.1�D�' <br /> 10505 19th Ave SE, STE C <br /> PROJECT ADDRESS <br /> Ownef Mail Address City SlalelZip Phone <br /> State Farm Insurance, 10505 19th Ave SE, STE C. Everett WA 98208 <br /> Tenant Mail Addiess Ciry State/Zip Phone <br /> Shoreline Siqn 8 Awninq 12101 Hucklebem Lane Arlinqton WA 98223 <br /> EIOClric3l Contfactor Maii Add2ss Ciry State2ip Phone <br /> SHORESA9812W $250.00 <br /> State License Number Contract Price of Work <br /> ProposeG Use of Building Contact Person (Plan Review) <br /> oescriPtion otwodc to ee�one: Connect LED illuminated channel letter sign to 120v, 20amp dedicated <br /> circuit by others. I <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �D -OO <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby caRily fhat l have read and examined lhis application and know the same fo 6e frue and ! ' / "" �/ <br /> correct. All provisions o�laws and ordinances goveming this lype ol wo�ic will be compleled w/ /[.FD�y_ � �[� <br /> whether spec�ed herein or not. The granhhg ol a permd does not presuma to grve aufhon(y lo (J / r <br /> violafe or cancel the provisions o/any other stafa o�Icenl law reguleting consfrucfion or the <br /> peAormance ol conslruction. Thaf I am authonled by fhe owner ol this property to perfo�m fhe <br /> work lor which applicafion is made and f comply wdh(he Sfate Confrac(ors Law 18.27 RCW and <br /> 296200 WAC. <br /> 1l � <br /> gnaturc Da e <br />