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ELECTRICAL PERMIT APPLICATION <br />GITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRE�T, EVERETT. WA 98201 <br />Q25-257-8810 - FAX 425-257-8E�57 - www everettwa org <br />APPLICATIONS ARE ACCEPTE[l FROM 8 AM TO 4 PM <br />_ , i , � �� � ' <br />i <br />PROJECT ADDRESS <br />% -� � <br />� ; �. . � ` l ��]� �� � �'- `��� , <br />Owner � 1 1.1ai1 Address <br />J <br />TenaN ldail Address <br />-i,� �' �� _—_ — <br />Fleclrical Coniractor Pdaii hddress <br />Stalc Lir,ense IJumbcr <br />Ciry <br />Cily <br />Ci�y <br />J t �7�" �L. , <br />StateZp <br />S:31e�Zip <br />Slate/Zip <br />' ',1�, <br />� <br />5�� <br />U���3 ��h�7 <br />Pl�one <br />Conlracl Prir.o ol Work <br />Phone <br />Phone <br />Proposed Usn_ �f OuilAin<� Conlact Person (Plan Rovlew) ! <br />r - • � I, <br />\ n I <br />� � <br />J /1 <br />' � �( � ��, � I'� I�'�] i�" L-/�� <br />Description of Work lo Be Done: _�„ I <br />NOTE �VIRING IN iJON-DW[LLINGS IS RE�UIRED TO <br />8[ IN RF,CEWAYS, P.1C OR AC CABLE. <br />CITY OF cVERE1T LOCAL SALES TAX CODE IS 3105 <br />1 hrr��by corLl�� fh;if 1 N�n�� r�.ad;iml r��,immrJ fhis upp6caf�on end kno�v fhe sarne fo be f�uc and <br />'� o�rrr�:f All p�or�.vuns nl Id�t s anJ oN�n,uires �7��,��crn�ng this .'vpe ol work will be complefed <br />�i �.�Imfher speuhed herern r� not 7he ��unlnig ol a perrnd does not presume lo give a�rthonty to <br />violate or cuncel Ihe provisions u/ any otlrer state or local law re�ulnfing construcfion or fhe <br />�� perin�mance ol cons;rucl�on Thnf 1 i�rn nufhonzod by the ownar ol thrs property to perinrrn the <br />', wnrk lor which applicahon �s made and 1 compty �sifh thc Sfa!e Confracfors La�v 18 27 RCW and <br />, 29Fi 20f1-1h'AC. <br />.- , <br />� ! .-,� :�l �t. � k,_� � �` C __ i " L. - (i % <br />FEE <br />L`JyOI i.0 `f <br />