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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR S-�REET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br />�- � ' " � � � , _ � �s <br />PROJECT ADDRESS <br />J� � <br />/!�� : ��.� 1.� ' �-��'�7(-�{.�i�,� . �����. ��� �� ,��' ��. J��� ��_ ���C� ��- <br />Owner � , � Mail Address City Slateilip Phane <br />Tenanl <br />`' <br />Eleclrical Conlractor <br />Sla�e License Number <br />of l3udding <br />Mail Adaress <br />� .'�'/ '; J /�%� <br />M11ail Addicsc <br />Descriplion ul Work 1�, [ic Uunc — ----'—_ <br />NOT[: WIRING IN NON-DW[LLINGS IS REQUIRED''O <br />DE IN RACEWAYS, h1C OR �C CABLE. <br />Cily <br />Ciiy <br />State2ip <br />Phone <br />Slaie'Zip Phonr <br />Contract Pr�cc o( Work <br />Conlact Person (Plan Revi��w) <br />.'� . -C'"�Ct� r. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hi�ieb}� r.ciLly Ih;d 1lcn-o �rad r�nd examined (his opp6ca6on and Ano�v fnc samo lo be hue and <br />i onect �lll provunins ol l:qts and oiAinancc�s poee�nm�� tlus Ippe ol uvrp �t�dl bu cornpleted <br />uhefher spec�hrd hc�rui or nof. The ginnGng oI a pernut dor:: not nesume fo give au(honty fo <br />�-ml�fe or cancrl fhc prowsians o! any ofher st�fe orlocal law �er�u�ahny conshu.:icn or fho <br />ue�lorniance ol cunsbuc6oa That 1 ant aufhorized by fho o�wer ol fhis prope�ty to perlorm the <br />�ruik loi �shiclr ap�dica!ion is madc:,and 1 comply �rrth fhn Sfalc Confractors Law 78.27 RCW and <br />291i 700 WAG. <br />i <br />,., � � � .. y . i! . G �. <br />FEE <br />���o�-c�- <br />