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ELEGTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> � 3200 CEUAR STREET, EVERETT, WA 98201 � _a/� <br /> 425-257•8810 - FAX 425-257-8857-www everetiwa.org <br /> I APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C I D6 ��`� <br /> I <br /> ►���3 r- <<xs,�� r�� <br /> � PROJECT ADDRESS <br /> L.-L-,r�el �o�e( S�n I�fO'3 [ �r,s��� ��� l.vere}} W/Q ��Z�3 3v39oZ <br /> Own2r Ma�l Address City Slale/2ip Phone Og 3 <br /> C�V-'V�t'.� <br /> I TenBnt Mail/ldtliess Clly StateQip Phone <br /> I ?,�� r <br /> Eleclncal Conlractor Mail Address City Slale�Zip Phone <br /> I — <br /> Slate License Number Contract Price ol Work <br /> IProposed Use of Bmlding Contact Person (Plan Rewew) <br /> �, Descnpuon ol Work lo Be Done �_"�� ��+��� ��' � �`B /` <br /> INOTE� WIRING IN NON-DWELLINGS IS REOUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABI.E. <br /> I CITV OF EVERETT LOCAL SALES TAX CODE IS J706 <br /> 1 herofry ca�hly flral I have read nnd c�anurred Ilus appbrabon anA hnow(he snmr, to he fnio and <br /> coner.f �II prov�sinns ol l;nvs and rndmdncr,5 gnvornmy fhis type ol�tnrk nvll he romplo(eA <br /> n�hnlhei sPea6rd huiern or no! The 9ranUng uln perrnd does nof nesurno fo grvo aufhonty fo ; � . <br /> vrol,tle or cnncel!ho provr5�orr5 0l any n(ha st,tfn o�/o�'aUa�v ro�u��hng conelructinn or Uro ,� <br /> ' portornranco ol rnrrsbuchon Thaf 1 em aufhonmd hy the o�vner ol f/r�s p�operiy fo porlorm fhe <br /> � �rrnh lor �vhiclr;�ppnralion rs n.�de and I cornply a-rfh fhe Sfale Cnnt�acto�s Law 18 77 RCW and ' I i <br /> . :96 200 WAC , <br /> I l <br /> , �.���� ��C! �/z/ � � <br /> r_.. 9gnalwe Dale <br /> i. . _ ____—_._- ___ ._. . ._..__—____.._.__ _ . <br />