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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 - DEBIY 8 CREDIT CARDS ARE NOT ACCEPTED <br /> �� � . � i� <br /> PRO.�ECT ADDRESS <br /> ' . ' . , /� <br /> Ownr,r A1a�,qddress Cily Slalc/Zlp Phonc <br /> Tenanl Mail Address Clly Slale/Zip Phono <br /> . � ' , , . . . ;.i,'.� J . /, . / �-�/��' J % �I ���. � .1,�--� L�/I/ !.!; J �7 i'l.c' '/ .,' � ' �//1 <br /> E'r,clrical ConUaclor Mail Address Cily Stato/Zip Phone <br /> , , . , <br /> Slato Lir.enso Numbcr Contract Prico of Work <br /> ` `' ' — <br /> PropoSed Use o(Duilding Contar.t Person (Plan Reviow) <br /> Descrlption of Work to B�e Done: � '- � , .'i� � �� � ��./. / � <br /> - � �� . !.� / . <br /> NOTE WIHING IN NUN-DWELLINGS IS REQUIRED TO FEE <br /> 9E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES iAl(CODE IS J105 <br /> I he�eby cerLly�hat I have r�ad end exarnmad this applicafion end know th�s�me fo Ge In�e and <br /> coner.f. �9 prevrsions o�laws anA ordinances,qove�nmg fhis type o!work w'll be complefed � <br /> whefher specihed herein or nof. Th�r grorrbn�7 0/a pem�d does nof presume�o give&ufhoiity to <br /> via'atr, or cancel fhe provisions ol any ofhe�sfa(e or locnllaw regulatin�consfrucfion or(hF <br /> pmforrnance ul conslrucfion. That I arn au(ho�ized Gy the owner ol lhis property fo peAorri fhe <br /> work lor which opplication is nrade�nd 1 cornpty wiflr the Sfate Conhn�to�s Law iB.27 RCW nnd <br /> 7J6.200 WAC. <br /> i, .. . . . , ,�, <br /> --�-- S�gnalure Dale <br /> /7 <br /> FU �; (J�'� �/L�� <br />