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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 AIA TO 4 PM <br /> , i � (� � �E��/9U / <br /> F OJEC�S <br /> �F �o i��> s `���� ro� j;�i i� 5 �✓_p ,��7� �'�cs-,zs�.� -1�.z <br /> OWner Mail Addross Cl�y Stale2ip Phonc <br /> Tenant Mal�nddress ciy� State2lp Phono <br /> � <br /> . ,- ,CC <br /> 5.. ,,,,, �: � ,� <br /> _ _ - - --- _ ------ -- <br /> [I,cliirul Cunlfnclo� 1.1ad FdAmt.� Cdy Slatr21p Phone <br /> Slale License Number Contracl Prico of Work <br /> PrupoSed Use o� �uildiny Contact Porson (Plan Review) <br /> Description of Work lo De Don�: ����C�an-�`e—a— � u��.''l � //� U��'.0 <br /> �^<' ��I �.^--t' <br /> NO1 L WIRING IN NON-DW[LLINGS IS REOUIRED TO FEE <br /> [3[ IN RACEV���YS, �4C OR AC CABL[ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I heroby c��rtJy fh�t I have ieaC ond exnmineA fhis applicntion end hno�r the sanie fo be fruo end <br /> roirecl AII ONV1510115 OI Iaws and orAui:�nces qoverninq this t}�p�o!h�o�k�rill Ge complefed <br /> �rhrthrr specilied hr.rcin or noL The gianlinc�o/.�pennrt Aoas nof �resim�o fo givF aufhority to <br /> ��iolnte or cancel Uie novisions ol nny ofher stufe or locnl law re�u�n6ng conshucfion or fho <br /> perlonnnncr, ol cnnsLuc(ion. )hef f nrn n�dhnrized Gy�the rnvner o/fhis property fo peAorrn fhe <br /> wo�h !or which�pphcafion is rrredo end I cnmply wifh fho Sfata Contracfors Le�v 18.77 RCW and <br /> 79fi.'100WAC. , . � ( / <br /> � �i� � <br /> / '� /, / <br /> � � � i ' <br /> _ '..azt.::`�'—'�1" �`� ��-.n.-��� � •,� <br /> � Srt1n.dWn Date ��. <br /> i` _ <br />