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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 P�9 <br /> ��CCC }�� I �/, < C <br /> PROJECI'ADDRESS <br /> `> �, r � � , � s <,�.e �. e <br /> Ownor Mall Addross Clly Slate/Zlp Phono <br /> Tonanl Mall Addresa Cily Stato2lp �'��o�a <br /> Cl�,� � <br /> � 5 % l« l, , 73/ 25.�,��! s/ ,t �c- �f«,�.-�� .�' c--��► �gZ�i2 <br /> EleclrlcalCoNracb� MailAddreus Clly Slale2lp 7C[����Phone <br /> �-z��v <br /> l r��,,c,c:� <br /> �� �<< �' i- � � � � ' ���� <br /> Stalo License Number Con�racl Price of WorF: <br /> P�oposcA UsA ot�uilding Conlacl Person (Pian Roviow) <br /> Doscription o1 Work lo Do Dona: ���,�� - ` ��' " � "��- <br /> i — <br /> NOTE: WIRING IN NON-DWELlING3 IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CADLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hnreby cartily Uinf I have road nnJ exnminoAfhis applicafion und kno�v fhe sanw to 6o fruo anA <br /> corrert. A;1 piovisions cl la�vs r�nd ordinnnc�s�ovenun�fhls typo ol work will bo complofed <br /> �rhefha�specilicd hc�ein o�noL The �ra�ifin�o(a pemtrt Aoes not prosunm to givo oulhonty fo <br /> vielafi�or cnncd fhe/�ruvisions ol mry ofner sf.+fo or locnl lnw rec�u/ofing consVuc6on orlhn <br /> pmlorrnnnce o/conslruc(ion. Thnf 1 em uufhoriri�J by fhe o�vner o/fhis property fo perlonn Ihe <br /> work lor�vhich npplicnfion is nmdo and 1 cornpl}��+'ith fhe Stafo Confrncfors Law 18.27 RCW and <br /> 296.2001NAC. � (� � <br /> �� _ . <br /> ;� /� / /-/� 2��/ <br /> r <br /> �-- <br /> –����n iluie Uale <br />