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Apr. 5. 2017 3 : 06PM Sto 155 No. 9561 P. 1/1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-2578857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 110 2.0 1 AVs <br /> PROJECT ADDRESS <br /> ` ?Pal , 12s Lio Ls b42‘oc-Ic. %1Q z06-_ _-z 26 <br /> Owner Mail AddreSS City Slate/Zip Phone <br /> \ UbV AZO L Tu L 881062o6- X3 '-Z6 <br /> Tenant Mail Address City State21p Phone <br /> WI:1k GI rnwviuNt -rrct. 1.6130 7y-v- Am, S. k oc- %d <br /> Electrical Contractor Mall Address City State/Zip Phone <br /> 053-W2- 77 <br /> 77ZT ThLT rp b 341313.1 ' KIN <br /> Slate License Numb& Contract Price of Wo' <br /> Win , <br /> SIL.. <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Pone: ta-4-1 VoI tktt,C, VQCCiU IDitZA rA (jS') Fon. ft7 Qom) <br /> 1 <br /> NOTE: WIRING IN NON-DWELLINGS 1S REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> )(1(51CITY 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 <br /> 1.011 <br /> whether specified herein or not. The granting of a permit does not resue to give authority toviolate or cancel the provisions of any other state or local law regulatingm _ <br /> onstruction or the <br /> performance rnns!ruction, That I am authorized by the owner of this property to perform the <br /> work for applice 's made and I comply with the Stale Contractrs Levia18.27 RCW and <br /> 296. WAC. <br /> -117 <br /> Signa.re to <br /> FAKCSo 416 v 11:10 • <br />