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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEFETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wvdw.everettwa.org <br />s—li_o5 <br />�pSvS-�6 � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />� ,; , z <br />,}c 1�1� :o•„ /1v� E,.�,�{{ wq `�Sa o3 <br />PROJECT ADDRESS <br />J45J�� I hZlfc'1 �j30 %+iVJ:c��. �y� Lvtic� W/r. y8� �'S <br />Owner Ma�.4ddress Ciry State/Zip Phone <br />Tenant <br />Mail Address <br />City <br />Stafe/Zip <br />Phone <br />Kineiic E�eci+�c l�c. y3i`� 32G�' P� 5� ��,ll C�1�� G/A `180�'l �/zs)7(,6 �-iC-I <br />Electrical Contraclor Mail Address City State/Zip Phone <br />KFNL Tr L �j�°j mm <br />Slate License Number <br />S�9 IL ��.•`��I� fC .t�f��Ct <br />Propose Use of �uildi g <br />/� G•�n 1 <br />Description ot Work to Be Done: _/y ��CI �►n� l�9 � <br />4€z� � � 5 00`=, <br />Contract Price of Work <br />JG�� C:�r.��,o„5� �2�G� 276_ <br />Confact Person (Plan Review) I 3 fl j <br />C ��1 , C <br />i: � <br />�uT �r P�a�; � $g��,�<c� I..�:� �T✓, ta.��c��,,.,5 ' J��i 't,�i< [�.ineciiu�.. , So�n� <br />� ;��r , <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereGy certi(y that 1 have read and examined tl�is applir.afion and know the same to be frue and <br />correcL All provisions of laws and ordinances govermrtg fhis type ol �vork �vill 6e completed <br />whether specified herein or noL The granting o( a permrt does not resume to give authority to <br />violate or cancel the provisions o(any other stafe or loca/ law reguPting consWchon or the <br />performance o7construc6en. Thal I am authorized by the owner o/ this property to perform the <br />work lor which appli�ation is made rnd 1 comply wifh fhe Slate Contraclors Law 78.2� RCW and <br />296.200 WAC. <br />3 Z-o� <br />..,�,a,,.�� �_ <br />�'-h'�. <br />��J':� �P/vel� -Ol..h.� <br />FEE <br />S�� "�r�� <br />