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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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 3003 W casino 1zi. <br /> PROJECT ADDRESS <br /> BflG;nQ Cc>m o g Po BoX 37b-7 MS-t Fct' Sea-t-i-1� WA `�812'- <br /> Owner Mail Address City State/Zip Phone <br /> 1314 45-ca- Lab 4 44bs (�r,'j 1"nob e1_1q 1-moi <br /> Tenant Mail Address City State/Zip Phone <br /> 1/a l teV 1=leG1-ri 1 tQo Migrr4(1 CreOL PK.wV. fVereft q6-L{b7-,08 <br /> Electrical ontractor Mail Address City State/Zip Phone <br /> VAL)_E E.0 191 NIA 4 35:x'c - <br /> State License Number Contract Price of Work riL� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: ::�:M'Zt: ll c,"1•'+'on 01F IQW YbIrcoe control W►rin s. Fe WPB" <br /> tkan 10 dev►tees <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 /> /hereby certify that 1 have read and examined this application and know the same to be true and �- 1 (� <br /> correct. All provisions of laws and ordinances governing this type of work will be completed C i2© <br /> whether specified herein or not. The granting of a permit does notresume to give authority to <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That 1 am authorized by the owner of this roperty to perform the <br /> work for which application is made and l comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> aee!�� //. th3 Azole <br /> Signature Date <br />