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. <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.ever��ttwa.org `�`aa � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> ����CJ St= �vr�e'tF- /�1c.t�� �,� <br /> PROJECT ADDRESS <br /> S+�«�Ik,s-� `�o�lil �I�) Q�,�� S-� ,'��w�t'a,r(?���� LA-, �i �C�.� (�vtilxsZ-� a <br /> OWner MailAAdress City Stafe/Zip Phone <br /> St� c �� '7oZ9 S zzo-;►�s�- ,Ls nir w� `�8o3Z C <br /> Tenan Mail Address City StatelZip Phone <br /> 1l��Il�os, G.lar�tc IIO��I¢�� �l L«�h y��hUv E�I��r�4" C,��"�, �1�2v3 �425)UJ7—fk�s <br /> Electrical Contraclor Mail Address � Ciry Stale/ iZ p Phone <br /> UA� LEFC�"1 � Nft ��, S2S`� <br /> State License Number Conlract Pric� <br /> Re�L�I s��e <br /> Proposed Use of uilding Contact Person (Plan Review) <br /> DescriplionofWorktoBeDone: �iA�••a,�_� pn[I� rPC,�Ii�G��rs �',�r S�Pt°n ��I,�-1- . <br /> 4 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> ; �f5 � , �15 i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily lhal I have read and examined this app;icatinn and know the same;o be true and <br /> correcL All provisions ol la�vs and ordinances govarmng fhis type o/work will 6e completed <br /> whether speci�ed he�ein or noL Thr,granting ol a pemut does not resume to give aufhonty to � / <br /> violate oi cancel the provisions o/a�iy other state or local/a�v�eguPting construct�on or fhe � �U <br /> pedormance o/construc6on. That 1 am authorized by the ownei ot L�is property fo pedo�m the /,'� �� <br /> wuk lor which application is rnade and 1 comply�vifh the Stzte Contractors Law 18.27 F.,W and ; V`' <br /> 296.200 WAC. � <br /> �CP_C ��:�.c.Q1 gl LZ I a5 � <br /> Sir�na;ure � Date <br />