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D <br />MAR 0'r zo�s ELECTRICAL PERMIT APPLICATION <br />--- -� CITY OF EVERETT PERMIT SERVI(.ES <br />ITY OF EVEAETT <br />nqinr.erinq!Public Services 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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />6300 L=verq►�e��h �N�I�( <br />PROJECT ADDRES <br />Owner <br />(I�►11 <br />Tenant <br />( K i o 7� L�� Ic ��v�� U <br />Mail Address <br />(offgp, G5�0 Cve <br />Mail Address <br />U ►�. 6�llinc <br />���Y <br />q►-ee►1 w�, <br />1�1n���r L=��,��i� Servi�e� 133h 1 N <br />ElecUical Conlractor Mail Address <br />LRND��S�j�II�C <br />Stale License Number <br />(U�v�nn�r�iCtl <br />Proposed Use of Builoing <br />Description o( Wark to Be Done: � �� S I �� I I L ���� � <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS. MC OR AC CABLE. <br />Cily . <br />�Eth <br />Cily <br />hnM <br />Lirc�,+i <br />EV�?re <br />`�822�i ;LO-73S-31gq <br />Slate/Zip Phone <br />j� �v,� . � g 203 <br />5 ate2ip Phone <br />�ti �, �ti� . ���oos <br />Slalef ip ` Lho�77) <br />�f "S-5E <br />� E 0�'. UC <br />Contract Price of Work <br />I,iS �� h �i�ma►� <br />ontacl Pe on (Plan Review) <br />" � 2U�tmp C�r��.�� f Extensi <br />CITY OF E��ERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily fhat ! have read and examined this application and knoa fhe same fo 6o frue and <br />conect All provisions olla�vs and ordmances governin9lhis lype oI �vork �vill be completed <br />whelher speci6ed he�ein or noL The granting ol a permd does not resume fo give authority lo <br />violate or cancel fhe Urovisions o� any olher sfate orlocallaw reguPting constnic6on orfhe <br />perlonnance of const�uction. Tha! 1 arn aufhorized by the owner of fh�s propeRy to pedorm fho <br />work �or �vhich applicafion is made and I comp/y wifh fhe Sfale Contracfors Law 18.27 RCW and <br />296.200 WAC. <br />J"/_D� <br />� <br />, <br />�r' �-�.��� ', , <br />FEE <br />� � �• n�� <br />�G�U 3z��1 a <br />