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FROM :FIVE STAR ELECTRIC FAX NO. :2535380331 Aug. 05 2088 02:50PM P1 <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 s ,_p `� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM L v 8vg—c� <br /> PROJECT ADDRESS <br /> P refr�'S (2.1)0 5 .o - 32( 3 <br /> Owner Mail A ss City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Sir 2CI? t L' 2c>3Z Ss 7,--5-11 7:4‘0$4-2-Qi (-Oft 92.yo$ <br /> Electrical Contractor Mail Add rne City State/Zip Phone <br /> -7 <br /> / 2.l a$ rS"bo <br /> State License Number Contract Price of Work <br /> 3tP 53i 23 <br /> • <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: Sit/ c e ZJ00 1+44,st ?fC Gu uwk k P. i r <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 /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed SCacti <br /> whether specified herein or not, The granting of a permit does not resume 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 l am authorized by the owner of thisroperty to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and - a <br /> 296.200 WA C. <br /> 3/Siva <br /> '—Slgnature bate ;t)P (Sim f </GC, <br /> Q3Z S. St� '1 �C, <br /> 7 tAA4 wq- 42)40 <br />