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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 /� a —Ga <br /> 425-257-8810 - FAX 425-257-SP57 -www.evereltwa.org �Ot� O!—�1 / <br /> 7 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,'i C �(�- � /�,'�+ � ��f �� __ <br /> PROJECT ADDRESS <br /> � <br /> . i��� " -i-l' � �f�.� C / <br /> ! - � � %',' �_ I ,, r, _�_�'l 1 ' •-1 -- <br /> Ownr.r � 1.ladhtldiess City Slale2ip Phone <br /> Tenan� Mail AAdress Cily Slale/Zip PhOntf <br /> � �— � � _—___— <br /> [lectrical Conlraclor �-----ht�ul nAAress City State�Zip Phone <br /> Slate Liccnse Numl�er Contracl Price of Work <br /> ProposeA Use of Ciuildinp CoNact Person (Plan Review) <br /> � <br /> � <br /> Desr.riplion ol Work lo f3e Done'. /' '� . '• /�. �. , •� 5 i';J 7 1 '�� i(� � ,� . . C�.-� <br /> NOTE WIRING IN NON-DWELLINGS IS REQUIRFD TO FEE <br /> RF IN R�C[WAYS, A^C OR AC CABLE <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> 1 hereby r���irly fhaf 1 have roed anA ea���rmned fhis e�pplicnfion and kno�r Ihe s�mo��be true and <br /> coner.f All p�ovisiuns o!Imvs and ordmancrs�o��erning Ihis type ol�rork will ba cornpleteA <br /> �vlr<�tha spocJir.d hrvrni o� noL The yrantinp ol n panv(does not �resunm fo c�ive au'hority fo .. <br /> ��iolafe oi cancel the`vowsions of any other sfate or local Inw regu�nGng consVue6on or fhe I <br /> pn�lorrnanco o!consf�ucf�on Thal l am airthonzed by fhe owner o!thls property to perform fhe I <br /> work!or which apphcnfion is maAe and 1 cornply with fhe Sfate Confracfo�s Law 18 D RCVV end <br /> 296 700 WAC. <br /> ; ; <br /> ,i . <br /> , . S ,ir .. , � ; , .� � '� � - 1 - C� `i — <br /> _ . _-_�. Si�nalwi: DNr <br /> E(J�`ic( � cv�( <br />