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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.everettwa.org <br /> APPLICATIUNS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CS2EDIT CARDS ARE NOT ACCEPTED <br /> io�i i hIW�' 99 So�TM Su►TE D �,�E+zeT�r wA 9r,.-��,,� <br /> , - <br /> PROJECT ADDP.ESS <br /> �8 �4�r��n1 io5� � iY �q 5 ��tinkT� wA� 9B�o� ��)���-y�� <br /> Owner Mail�ddress Cily State2ip Phone <br /> �ERFo�vwN�E A��omo7ivE io7lr r��Y97s5vi�� D EvE,�7i wA , 9�Za`I (boo)77�-5337 <br /> Tenant Mail Atldress City State/Zip Phone <br /> �a�N�G� IIJD�S'f�Z.IFS IBy35 oLYn�Pic, �UES TuKWIUI (�UA 9�IbQi N2525/ /Boo <br /> EleCtfiCal Coniractor Mail Address Cily Slatc/Zip Phone <br /> �!INIfLo�S�I ExP /o •L! •U� � 1 �5�= <br /> State License NumGer Contract Price ot Work <br /> �av���v�cv� � �vNN m. k����s�,�► <br /> Proposed se uf Building Contact Person (Plan Review) <br /> DescriptianofVVorktaeeDone' l/�Slf�C.( �?-, � 1(7�{7� �i .'c LEN +ITN��[.UU�'FS(ENT <br /> , <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACE�NAYS, MC OR AC CABLE. <br /> 3�� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerfify thaf 1 have read and examined this applicafion and know tho same fo be frue and <br /> correcL All provisions o(laws and ordinances governmg Ih�s typo of worl:will be completed <br /> �vhefher speciEed herein or noL The granfing o(a permd does not presume fo give authoiiry to <br /> v�olate or cancel the provisions ol any other slale or local law rogulating construcfion or flte <br /> peAormance of consfrucfion. That 1 am aufhonzed by the owner o/fhis propeRy ro peAorm fhe <br /> �vork lor which applicafion is made and I compty with fhe Sfale Contractors Law 78.27 RCW and <br /> 296.200 WAC. <br /> � � /Cl-2/ •6�� <br /> iFnaWre — ate <br /> ` ` � <br /> 1 �� �/� /� <br />