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EL�CTRICAL PERMIT APPLICATfON <br />CITY OF EVERETT PERMIT SERVICES C{—�S—OS <br />3200 CEDAR STREET, cVERETT, WA 98201 �h <br />425-257-8810 - FAX425-257-8857-www.everettwa.org �OJOU-�/% <br />APPLICATIONS .4RE ACCEPT�D FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />� �1 <br />- � ' ( :�✓1 l. ��E- � <br />�� �j �-�� r.)�:^.I�r.V"��4 ��lr�t. �'jG� - kiiJ JZ <br />PP.OJECT ADDRESS � <br />) I. <br />Jlil�li_L.��: _. <br />OWnuf <br />Tenant <br />ii,i V.) f�l �„ � <br />Electrical Contr:iclor <br />, �, , <br />; � i;1 ;� �1 �� .. , � � � � � �. � , � ? ; r'.y' �- <br />`� <br />Add:ess <br />A1-iil Add�ess <br />P.1dJ �ddre;s <br />State Lixnse Number <br />�4 � - <br />�c.�_;� �A ,,-<<�a� <br />��_,,.,,,.. � z z� <br />Proposed Usr, of Building i; <br />Descrip�ion of Work lo �c Donc: �� ��-� <br />IJOTE: b'VIRING IN NON-DW[LLINGS IS REQUIRED TO <br />B[ IN RACEWAYS, MC OR AC CAE3L�. <br />Crty <br />Cily <br />Cily <br />� i >., <br />�,. . <br />Stale2ip <br />Sla�c'.'Zq: <br />Contracl Prir,e ut Wr.rk <br />�{-"L � <br />„ Ll � '_, }J (i � <br />Phone <br />Conta�;l Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />1 haieby cortily thaf 1 hace icad and cAumined tN.is applicafion and krow thn same to be V ie and <br />conecl. All provisions o! I�iws and o�dfnnnces povenung fhis type o/ �sork �vill be complefe d <br />�vhcihcr specilied hercin or ncL (he grvviting ol a penrid does nof resume fo �ive aidhor ly to <br />violale or rm�cel lhe provisions o! any olher sfa(e or lecal l.+w ieguPt�ng consf�uc6on or fh�; <br />peAomiance o/ construclion. 7hnt 1 am aulhorrzed by the o�rn��r o! fhis property to perlonn fhe <br />�vork lor which applicotion is made and I cornpl}� n�dh fhc Stat�� (,onfrcicfors Laro 18.27 RC�N a, ��1 <br />29ti200 WAC. <br />�, <br />� <br />� � <br />!� ���-,\`a'�, �.vJ ''��', �. <br />--�- - <br />si�nn�;u� _. � <br />FEE <br />� <br />Phonc <br />Phone <br />