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i <br />ELECTRICAL PERMIT APPLICATICD�i <br />CITY OF EVERETT PERMIT SERVlCES <br />3200 CEDAR STREET, EVERETT, WA 9820'i <br />A25-257-8810 - FAX 425-257-8857 — www.everettwa.arg <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />� ��'(l <br />I <br />��a,���. ��,�� f ���� �r, �s-a �-���l,�w;� <br />RROJEC7ADDRESS <br />Owner <br />Tenant <br />,.� r. � <br />Mail AAdress <br />Mail Pddress <br />Contrdctor Mail Address <br />EvcR r� � � 0 �r �,'�" <br />State License Number <br />'�#.�� �il r,n_ � �5,'r,r/1 <br />Pro 5eA se of Buil ing <br />Description of Work to Be Done: <br />NOTE: WIRING IN NQN-DWELLINGS IS RE�UIRED TO <br />BE IN RAC[WAYS, MC OR AC CABL�. <br />CITY OF EVEREIT LOCAL 5ALES TAX CODE IS 3105 <br />1 hereby certify N�at 1 have read and examined Lhis apPlication and <br />correct. All pro �. isions of laws and o�dinances goveming th:s type <br />whelher speci•ied herein or noL The granting ol a peimd does not <br />violafe or cancel the provisions o(any other stafe or local law 2gu <br />peAormance of consWcfion. That I am aufhonzed by the owner o <br />work lor which application is made anA I comply wiM the Sfafe Coi <br />ciry <br />SWIeIZip <br />StalelZip <br />Phone <br />Phonc <br />l �. Fr�t � Cv/� �(1s-7S�,;�- '�lacz� <br />City State2ip Phone <br />� 7sU C�G� <br />CoNract Pnce of Work <br />� C� <br />Contact Person (Plan Review) <br />, <br />FEE <br />� fo be hve and <br />complete�l <br />ie authont� to <br />!ion or the <br />o peAorm the <br />8.27 RCW and <br />� �,�,,G, � y <br />