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ELECTRICAL PERMIT APPLICATION <br /> CITY OF E\/ERETT PERMIT SERVICES �, , � _ � q <br /> 3200 CED��R STREET, EVERETT, WA 98201 <br /> 425-'L57-8810 - FAX 425-257-8857 —�n�ww.everettwa.org �� �''j U� ' �G� <br /> APPLICATIONS ARE ACCE�TED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> r� n I n � <br /> U,�F � � h1�5��' l ctil;! {j, ��X,l�llV�c�V(i� <br /> PROJECT ADORES� <br /> �t�A R���l�� l�(c( �,�o�, �K�rm�n Gvc; �rv�r,� C� ��;I� �l�q �1�5 `��`�1 <br /> Ownef Mail Address Gty SWte2ip Phone <br /> Col��nhia D�s��� lvti� (��II �i.55�c, �I�c� E�,�t'r� ��� <br /> Tenant Mail Address City State2ip Phone <br /> 11� ,. � 'U�tV`, f �('f11 �-IU�1 �1Cf���, 11.�Ui �o_ S�� � G�4�( �� �� C�� (�,p?,(�,. <br /> Electrir,al Contt� Matl Address ��� Ciry Slate2ip Phone <br /> �M `� Q� � �^ <br /> U 1.1�1\��ltil�(u5 � � <br /> Slate License Number Contract P ice of Work <br /> Proposed Use of Buildin9 Conlact Person (Flan Review) <br /> Oescriplion of Work to 8e Done: �•Y1 5lti�l -��k r(�J��31Y�V1:,`,� ��l e`'m�5"�.�%� <br /> NOTE: WIRING IN NON-CWELLINGS IS REQUIRED TO FEE <br /> I BE IN RACEWAYS, h1C OR AC CABLE. <br /> i <br /> li CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> !he�reby cnrtJp rhdt 1 ha�e �eaC an;1 ea�vnined:his 3pp6;aftcn and kneW the same to be frue ano <br /> �, .�rrect AI!prewsio�s olia ws dnU vomances gcvenvny(his type ol work �wll ba comple(ed <br /> � �vnether specdieo nerem u r,cG 'he gran6r,g o/a permrt dces nof resume to give authonfy to <br /> nolate or :ance�the provi;�ons ol any other state or local iaw reguPLng construcfion or fhe� <br /> . peAormance o/construch�n Thet I am aufhonzeAby the ewner�/this preperty to peAorm the <br /> �vcrk lor which applicatian is maDe and I comply wdh the State C:nhac;or5 Law 18.27 RCW and <br /> �'96.200 WAC. <br /> � _ ��� -� / � <br /> , <br /> '��- '���r��r,�,� �1�1��, , - �,�� _ �C�/ <br /> S�gnatJre � L7ale � <br /> I <br />