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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 - www everettvi org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />5a4 l3rc! 5+_5W <br />PROJECT ADDRESS <br />H0-1,9l 3I5' 2-0 <br />/V" ; k,.l say 93 rd srs w 5,ut-4 WA 98avff <br />Owner Man Address City Slatel71p Pnrine <br />_ 7aLAOSe <br />Tenant Mail Address Gh Staler2rp Vhole <br />31�o�9Y-73 <br />llr�s Irl-�-.�• c�oi►,� Fr�� �r� �;eo � �u�s�rv��,troe wA �Sa-7� <br />Electrical Contractor Ilan Address rr SlatelZip Pnone <br />(aS IT T (rS hl 930 E /,00000 <br />State License Number Contract Pnce of Work <br />Stq It F4+11 , l u DaANr 8211Awe <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done rV�S �q LS-ak4_ Oy aftit p aH 0 V (_Ire--+ W <br />e)a Akt i-5 b 3l+ • Dai­Nc.ss hleaL4 Rt-w,0 citsd At� Ws_ <br />NOTE WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 - <br />1 hereby certify that I have read and examined this application and know the some to he true and <br />correct All provisions of laws and ordinances governing this type offmwork will be completed �Q O y <br />whefhef specJred here,n or not The granting of a permit does not resume to give authonty to ( <br />violate or cancel the provisions of any other stale or local law regu ag construction or the I5 <br />performance of construction That I am authorized by the owner of this property to perform tkc <br />work for which application is made and I comply with the State Contractors Law 18 27 RGkD and <br />Signature Dale <br />3 <br />