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ELECTi�ICAL PERMIT APPLICATIO(� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET [VERETf, WA 98201 <br /> I 4�5-257-8810 - FAX 425-257-8851 - www everettwa.org <br /> APPLICATIONS ARE ACC:EPTED FF.OM 8 11PA TO 4 PM <br /> � � <br /> , „ <br /> PROJECT ADDRESS <br /> •'i' i_s=�'7�- �S S / <br /> �.. , � <br /> ��i�� i �l—li, ,: ;�k;,� i ' .",ii,: � _ � 6 �' i"� �� `�S),; <br /> Ownur I MaA Address � City State/ZIp Phone <br /> Tmiant Mail Add�ess Cily SlateiZip Phone <br /> Eledrical Coniractor ldail Addrnss City Stato2ip Phcne <br /> Statc Liconsc Numbcr Coniract Price ol Work <br /> � . i <br /> ' �% � y �Y/ . /i'�� � ' — <br /> Pruposed se Buildin� Canlac� Porson (Plan Review) <br /> Uesr.rip�ion ol Work�o Ge Dono: '�� ' �'f f'�,_Ji��� [i�1 �.//i , Ii'i�i'��Jl, ����:�� <br /> Y� ' — ✓ <br /> iJOTE WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RAC[WnYS, MC OR AC CABLE. <br /> CITI'OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I ho��b} ro�hly fh�if 1 have roed nnd eenrnuu�d flus applicnfion end know fhe sarno fo Ge fnio ond <br /> ����nnct Ali provisions ollaws and oniinancas govamng thls fypo ol work�rill be comp�efed <br /> �tholhor specilicAherein or nof. The pranhn��ol n pe�nu(does no�prosunte fo give d�Chonty fo <br /> ��olafe or�nncel fho`novisions ol any o(hcr sfate o�/ocal law regulnting conslrucUon ur fhe <br /> ��rrformance ol cnnsf�urfion. Th��f 1 arn aulhrnized hy fhe on�ne�ol fhis property lo pPrton:i fhe <br /> �t�U�A(Uf�5'IIICII A(1�111CAI/Jf115 l71AU(!8�1(11 Cofll�ly N'Ifll UIB SIBIC COOUactors Law iH2 RCW and <br /> 7f>6 200 WAC. <br /> _' i� ��' ;J/�7 ,'S� � ! -a�l�� <br /> ipnalur Dale <br /> ✓ <br /> .�_�.1 � - f � f��i <br /> l>� <br />