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r <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.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />PROJECT ADDRESS <br />Owner I Mail Address City stalelZlp Phone <br />- / \ L" k )'\ CA _N (A I if to <br />Tenant Mail Address City State/Zip Phone <br />k)0Q-VN AmF(LICANyinrc, 3210 .5mM e-y Pr 71 *LIzr3 APLINFsTa/V L.UA <br />Electrical Contractor Mail Address City State/Zip Phone <br />%JDILTH4uq-11 RE _8eO06 <br />State License Number Contract Price of Work <br />�LA%(t= E OA .tr-FIrVS- /FRL <br />Proposed Use of Building Contact Pe on (Plan Review) <br />r <br />Description of Work to Be Done: 'X7A) S't 61 L N-o CLA) / S T-{2_b R _ F S T206 5 <br />R E S T A- C a A—A.)1- <br />T. <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. c <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />AIL, <br />1 hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances t his ap l i this type of work will m completed <br />whether specified herein or not. The granting of a permd does not resume 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 I am authorized by the owner of this roperty 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 W <br />5—d7—o5 <br />ignature Date <br />