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12:13:20I2 IL'32 FAX 4253357830 VARNE.I.I. ELECTRIC <br />[�002i0a2 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />TH <br />4sa9 —Z /kJE S� <br />PROJECT ADDRESS <br />B60 ��� 5132 <br />F.r,L F Couq,V-'? l i) C ?.0. 3o,r 130H AtAYSYIl a& WA <br />Owner Mail Address / City State/Zip Phone <br />n!//7 . ti�F . Z—tom n S7 2✓ G 1 t /v <br />Tenant A1all Address City State/Zip {.b�1Ph ne <br />-7 <br />CT-S E n1S VJA qS u^ 6 <br />Electrical Contractor Mall Address city State/Zip Phone <br />VA2.,4r-C-J:g79/1-1 �lu-oo <br />Stale License Number Contract Price of Work <br />Sf R _ <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: <br />�- <br />NOTE: WIRING !N NON -DWELLINGS IS REQUIRED TO FEE <br />BE INRACEWAYS, MC OR AC CABLE. O <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the same to be true and <br />corroct. All provisions of laws and ordinances goveminpp this type of work will be completed <br />whether specified herein or not. The granting of a perm7t does not presume to give authonty to <br />' violate or cancel the pro s of any other state or local law regulating construction or the <br />performance of constru tlon. hat I am authorized by the owner of this roperty to perform the <br />w rk for which appllcat n Is m de and I comply with the State Contractors Law 18 27 RCW and <br />2 .200 WAC. <br />Signature Date <br />