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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREl'T, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.ev�rettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> ) �-I L 7 L �Lt' ��-11 ���I 5�- <br /> PROJECT ADDRESS <br /> � <br /> y a5 <br /> �6:��,� ►,�> > ���� �' 1 yc� 7 Ck��`+ r� ���,��' L�%>T�� �til,� �,��� �,�S��l <br /> Owner M1fail Add�ess Cily State2ip Phone <br /> Ten�nt ldail�ddress City Slale/Zip Phone <br /> Elcchlc.d Cnnlraclor Lt:nl�dd�r�a; ���� City Statc�Z�p Phon� <br /> S�aie License Number Cuntract Prir.e of Wurk <br /> ProposeA Use of�uildin� Conlact Pcrson (Plan Review) <br /> Dusaip6on nl Wurk lo�c Unnc_ --- <br /> NOTE: WIRING �N NON-DWELLINGS IS REOUIRED TO FEE <br /> B[ IN RACEWAYS, A4C OR AC CABL[. <br /> CITY OF EVERETT LOCAL SALES TAX CGDE IS 3105 <br /> I hcrrbV cartrly fhn(1 h;���e rcaJ��nd eaanunrd fhis apphcnhon and Fnou�Ihe sarne fo be true and <br /> cunc:L All prov�sions ol la�ss and ordmances qove�nmg fhrs f}pe ol worF wdl be comple(eA <br /> �chefhe�speci6od herem or nof. The gran6ng ci/a permd does not uesunie fo give aufhority to <br /> ��ioLife or cancel the p�ovisions of arry ofher sfafu or local Imr mgu��6nc�consfruclien or fhe <br /> peifnrrnance ol construction. Thef 1 am aufhnnzr.d by fho ewner ol this propaty to peAorm fho <br /> �vo�Alor whir,h application is niade anA1 comply�tivth fhe State Confrac(ors Law 78.27 RCW and <br /> 29G200 WpC. <br /> C_ �I � j I .� �' /L; �" <br /> siqn;�"�Ve�-- -- u�� f <br /> ;��� -/ S <br />