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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES q _1cl_C75 <br />3200 CEDAR STREET, EVERETT, WA 98201 /.=-17 <br />425-257-8810 - FAX 425-257-8857-www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />rc `1 19 15tteriree11/4 z <br />PROJECT ADDRESS <br />150 v L'iN 1l741nCAJ+r... 3/f/L Se I.I �F�e [re+e..F F 144 <br />Owner Mail Address City State/Zip Phune <br />Rig, URMS 13(3Q 41/1 fue-ryree, i�t;e 1.4 <br />TenantJ Mail Address City State/Zip Phone <br />y aS- <br />Ue-rrg lV ecea co 7//Co Wq,-,45., Pk' £vc ef/- Grit- SS zu 3 776-93.5- <br />Electrical C nlractor Mail Address City State/Zip Phone <br />��rr�Nco Ss'G3 $ /00. o=' <br />State Licens Number Contract Price of Work <br />re,S4-�r-4,;r S/e n ?Loin 4 <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: GLShIt C/) L..f-1 1 0 Srj .0 <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETr LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know the same to be true and ock- Oki <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specifiec herein or not. The granting of a permit does not presume 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/ am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />&TnatufeP Date <br />%� /7 <br />