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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET T, WA 98201 <br /> 425-257.8810 - FAX 425.257-8857-www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROJECT ADDRESS 1 <br /> j(f'cK Tlwoon ? 7 `l �'' C sk EyeF&# Wf J?f0 355 og�+ <br /> Owner Mall Address City Statelzip Phone <br /> W / 4 <br /> Tenant Mail Address City State/Zip (Y'2�e) <br /> Lida Electra ;;0357 TQC. 101) St k,11bvu&, WR 79005 5612- 1711 <br /> Electrical Contractor Mall Address City Slate/Zip Phone <br /> LAV46ESIII 6C <br /> State License Number Contract Price of Work <br /> Sin Ie) Fr1MIl (z- ^I < enfmL Kh t n 'i1m<I,� <br /> Propo!qU Use of Building j <br /> Contact Pers n (Plan Review) <br /> Description o1 Work to Be Done: I v r � ) �Ql P ► r <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. 41oC' <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 1105 / C/ <br /> 1 hereby certify that I have read and examined this applicafion and know file some to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to �' �1 <br /> violate or cancel the previsions of any other state or local law regulating construction or the _ <br /> performance of construction. That I am authorized by the owner of this roperty to perform the `Q` \ <br /> work for which application is made and I comply with the State Contractors Lew 18.27 RCW and O <br /> 296.200 WAC. <br /> ' � 1_/C`t /07 <br /> Signature Date <br />