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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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> � <br /> � r�� t,. 11( �' ��� _i � ' 1 <br /> • � f.1/- � �� � t �- l /� ��_�� <br /> PROJECT ADDRESS <br /> - � . — �L'c��TT IA/fs' <br /> Owner Mail AAdress Clty StalelLp Phona <br /> Tenan� Mail AdAress Cily Slate/Zip Phone <br /> lJ �lic:/� fJ�� 5� [ �-,C'� f�� �.FA71�� lti/�. �/U.Y �v 1/. J .Z �.�, <br /> Electrical CoNrador Mail Addmss City StalelZip Phone <br /> �'-' -+-�c., c /1 /� / -� <br /> / ' �i .l ��-�� �5�+ ,rt �!-_� V o�7 -�.) ���� <br /> Slate Lic�nse Number � Conlracl Price of Work <br /> Proposod Use of Building Contact Pmson (Plan Roviow) <br /> Descriplinn ol Work to Bo Dnnc: � C C c .Z', i��,��i J'i; c <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACFWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � <br /> I heroby ce�U/y Ihat 1 have reod and examined this;ipp6calron anA know fhe seme l0 6o hue and <br /> correcf. All prov�sions o!laws end aiAinances�7overnmg tlus fype o!work will be cornplefed <br /> whefh�r speci6ed herr.in ni not The gr�nfin�al a pernuf docs nuf iresunw to qive aufhority fo <br /> violafe�r cnncel Iho provisions o!any other sfafe or Inr.al law requ��tinp conshu�lion or fhe <br /> perlonnance o/consfruction. Thaf f�rn authomed by fhe ownei o�Ihis oroporty fo perlann Ihe <br /> wo�k lor which npplicel;on is rnnde nnd 1 cnrnply�vdh fh�Sfale Contrncfors Lnw 78.27 RCW nnd <br /> 296.200 WAC. <br /> � % / i.� / - <br /> �'-��S�n ure t.�"'� ..�.__ ,�� �� 7u/� .ti <br /> ��'/ Ual� <br /> ' c <br /> � FQScS - iG1 <br />