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i � <br /> 0. <br /> 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 <br /> ' -F 1 ) <br /> ��� - �V��� �Il" 1 �� �, ; 't�l, � �111 �; . <br /> �- <br /> PROJECT ADDRESS <br /> / � � ' ' �'.� i �� i � i�� i i�{� � <br /> �{�' , �,,'��� �- jl� , 1 4�� � � J� �i �� f �?-�-; U� )` <br /> OWOef �' Mail AtlOress Ciry , Slale/Zip Phone <br /> � `` .`, <br /> � �. . , 1 �I�, � � �� i <br /> ��i ' + . <br /> TenaN � MaA Adtlress Ciry Slale2ip Phone <br /> J 1 1 i i (� 1 ( � ' �"�' �� ��� 'G ��� ) �(-�t _ ,-_ L�' '� ��ii� <br /> �I ��n � 1�r � ��l � ����\ �� � � �V ��V��'.�'\f I � '� ��f 1 ���1 �_� <br /> Eledncal C:oniraCtOr Mall Atldress Cily StatelC�p Phone <br /> �,� ,��_� �, � t ,� � � �,,: � �� ��.1�1�� _�. <br /> � , , . . . . , <br /> State License Number � Contract Pnce of Work <br /> „ � � �, � -� <br /> , �,,� � ,��� '� ,�i � I; � � � P � l,i "'�'�1��'','f <br /> � (' � , <br /> �'�oposetl Use of Bmlding � Contad erson �Plan Rewewl <br /> r <br /> � � '; � ' 1-� I � _�,. � �'V . � , ��)'��� �_�P ;� �, � j1 <br /> Descnption of Work to Be Done _ �� - .y,� � � � � � 1, f <br /> �,l � , — <br /> NOTE WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE �`-.� �, 4�_��� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> I ho�oby corirly that I havo road and cxanuned fhis apphcahon and Anow Ihu sarno to bo frue and <br /> r.ronnct All provisons ollaws and o�d�nances govemmg this type ol�vork wdl be complofod <br /> �ahefhe�speciGed horem oi nol The gran6ng ol a pennrt Joes nol rosurno ro c�rvo ai fhonty fa <br /> � . �4�te or cancr,l Iho p�owsrons ol BOy OIhCf SId1C OI IOG91 I�R'/C(JUPhng conslmcf�on v fhe <br /> p�rfonrranco oI consfruchun Thal I am aufhonzeAhy flre ownnr nl fhis property fo pedomr flro <br /> work/or wh�ch app4c�f�on is mada and I compty wdh fho Sfafo Confmclors Law iB 27 RCW and <br /> 296 200 WAG � i <br /> � <br /> � , - <br /> �, . � � � i .�' : , �.- , , <br /> � Siqnal e . �. . ��Dale �–G6�� 1'1 7� <br />