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ELECTRICAL PERMIT AP�LIGATION <br /> CITY OF EVERETT PERMIT S1=RVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857-www.everetiwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> �1���� 1`iTi� PcVE SL. ��zT�. A�—�o°I <br /> PROJECT ADDRESS <br /> MA'��fJEdL C l.l�f SNVESTMENT llL. PO BQx (05�( 5,bttON4TSH 9�z-`'� � <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> C�.YMPS(. r11�C�Ff�NSCaC. ��1C � t'Ak' 53�� �yNtu�.�.no0 W� Ryp�{b N2S-77y-994� <br /> Elecirical Contraclor Mail Address City State/Zip Phone ', <br /> o�yMPMTm� 2�G- � qo°' � <br /> State License Number Contract Price of Work <br /> _ O Ff�k,�- I�Y� l.yN�� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: �NS'�PSG(. LDw VOLTrCCrE.. l.�fL� E. fde 'S- <br /> Tk�C�Rw�.oS� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RP.CEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify thaf!have read and examined this application and know the same to be L•ue and <br /> cor�ecG All provisrons of laws and o�dinances goveming this type of work will 6e completed <br /> �vhether speci6ed herein or not. The granting o(a pe�md does not presume to give authonty to <br /> vrolale or cance/the provisions o(any other state or local law regulating construchon or the <br /> periormance of censtruc6on. That I am authorized by the owner of this property to perform the <br /> work(or which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> /��--- q-3-oY <br /> � ure �ate <br /> �!� `� - � 5 <br />