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� ; <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES s—�-o7 <br /> 3200 CEDAR STRE:ET, EVERETT, WA98201 �,p-��$-p( 3 <br /> 425-257-8810 - FAX 4a5-257-8857 -www.everettwa.rrg <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT��CCEPTED <br /> 1(19�1 19th ave SE Everett. WA _ <br /> PROJECT ADDRESS <br /> Chevron ProduCte CO 145 S State ollegP R�� � Brea ('alifomia 92R21 (714� Fi71-"i39� <br /> Owner Mail Address City State/Zip Phone <br /> � ,Pvron 10971 19t1t Ave SF };v r�tt WA <br /> Tenant Mail Address Ciry State/Zip Phone <br /> I ��I(' �[A SI t I �(' Pn R(�� 2A49 Rentnn WA 9R(15fi (4�51 917-�1a� <br /> EleClriCal ContraCtof Mail Address City State/Zip Phone <br /> INSIGSIOSSJS _ $750 <br /> State License Nuraber Contract Price of Work <br /> Gas Station with Food Mart �'�n�y Thomaon <br /> Proposed Use of Bui�ding Contact Person(Plan Review) <br /> oescriP�ion ot�vork�o ee oone: Hook new LED ]ight bind to existingPle�trical circ�itc All other signs ar <br /> ••Rctacc"onlv. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IM RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby c2rtif}�that 1 have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing tnis type c(work will be completed <br /> whethar specified herein or not. The granting o/a permrt does not presume to aive autbonty to <br /> violate or cancel the provisions of any other state or local law reyulating construction or the <br /> peAormance ol construction. That 1 am authorized by the owner of this property to perform the <br /> w for which a lication is made and I comply with the Stafe Contractors Law 18.27 RCW and <br /> 2 6.200 WAC.� --- <br /> / i / <br /> ,�,�� � j� � �� -� ��� - �<" � <br /> ;_�ilnr� , ��� � <br /> Signature Date <br /> I <br />