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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SS <br />PROJECT ADDR <br />Owner <br />Mail Address City Stale/Zip Phone <br />U; «cHu(aSE c"'a AAJI WL X 101 ry-e 4 Wbg 11a6-3s5-aneo <br />Mail Address City State/Zip Phone <br />1 /Tenant <br />MGtrD r <br />/' n / <br />L LLIf ✓ )-Zz 10 JG S. 65 L 0 bl a53 3o�/-SSos <br />Electrical Contracto <br />Mail Address City State/Zip Phone <br />any v <br />L`1,e ! 6f � to �a � �I <br />r <br />Contract Price of Work <br />State License Numb <br />1?el,^ziI 1 <br />p <br />do 9 �UZG F,os� �i...won`� <br />[ding <br />Contact Person (Plan Review) <br />Proposed Use of au <br />Description Ot Work <br />j( 1 % <br />o Be Done: 2 n'1 1 z 1 %2 r , <br />.a.. I"Ip�� <br />TZ <br />NOTE: WIRING 11 <br />BE IN RA <br />NON -DWELLINGS IS REQUIRED TO FEE <br />EWAYS, MC OR AC CABLE. <br />CITY OF EVERFTT <br />73n 1 V <br />OCAL SALES TAX CODE IS 3105 <br />I hereby cenlly that <br />correct. All provisi <br />whetherspacI etl <br />have read d examined this application and know the same to be true and 1 <br />s oflaws ahh ordinances goveming this type orwnrk will be completely <br />rein or 15 /1'he granting of a permit does not presume to give authority to <br />vinlale or ca cc l a provis! <br />/ts�orany other state or local law regulaling construction or the <br />performanc of n tructio <br />work for tv lch ppii <br />. hat 1 am authorized by the owner of this greperry to perform the <br />ation made and l comply with the State Contractors Law 18.27 RCW <br />296 200 AG <br />and <br />St at <br />Date <br />�, :aeed LS88LS2S2bT of 6L96ST9888 dNl:woad £2:TT TTO2-82-1JO <br />