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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVEFtETT PERMIT SERVICE$ y_� 6_bs <br />3200 CEDAR STREET, !:VERETT, WA 98201 <br />425•257-9b10 • FAX 4?.5-267-8857—www.everetlwa.org �T o �9 -0�'S <br />APpLICATIONS ARE ACCEPTED iROM 8 AM TO 41�M - DEBIT & CRCDI7 GARDS ARE NOT ACCEPTED <br />:L��a7 / UGvor��7 ��l/%�% � (� <br />PRO.(ECT ADDP.ESS <br />� /i�a. , .� „L'^ ��*" r i� � <br />OWner ail Addr�ae <br />Tenent <br />Mall Addrw <br />Ccnhactcr (/ ni.�i add2s,. <br />State Ucenae Num6er � <br />Propoae0 Use af Bulltling <br />c.y <br />Cly <br />Clry <br />� � � <br />Descrlptlon of Work b Be Uone: '�✓ i I' r �C'� �� m'v <br />NOTE: WIRING IN NON-OWELLINGS IS REaUIRED TO <br />BE IN RAGEWAYS. MG OR AG CA9lE. <br />CITY OF EVEHETT LOCAL SALES TAX CODE IS 3105 <br />Sulo/dp <br />SntuflJp <br />ShtslZip <br />Contract Prlce af Wofk <br />c;ontea Person (Plan Revlew) <br />i here6y certrly fhet I heve reed entl eramined Ihls eppllcaf/on nnd know the seme to be true end <br />comecf. All provisions ollaws and ordinencas govemmp this rype ol wVrk will ba comp/efed <br />whathar spanfioa haroin or net. Tba pranGnp ol a plmf7f does nol rasumo ta piva au(horrry� to <br />viole7c or cence/ fhe pru� �;�ons of eny othe� stete or locel/ew repuPhng consbucHpn o� t�a <br />penormanra u; construcNc • That / am authonred by the owner o/ tbis prop�rry ro poAo�m fho <br />w0lkIp� Wflltb 6ppllGAfl01115 rt1BtlE @Ild 1 CCmpl�� Wl(p f�B S18tB C00flAClory �aw 18.27 RCW end <br />P96 200 W.4C <br />FEE <br />X c, 5 o S �tiS <br />Pha+e <br />Pnon� <br />Vhone <br />IO 3E"�vd 1J3�3 1H9I'1 Ntl3H1tlON 8LSB65509E SS:LO 500Z/9T/60 <br />