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P�l�r. h. 2�91� I?:43P6i � iJ��.7569 P; <br />• <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREFT, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257•8057 — �wnr�.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />aJJ,D � <br />PROJHCT ADDRESS <br />� ONner <br />� <br />ITenant <br />AU�iAddrosc <br />Mali ACd�ets <br />CI!y <br />Ciiy <br />, EIecVIcal Contractor � '!WI Addims � Clly <br />fl <br />' Grl+lGAdNqoiaq <br />ISWIoL�tenseNumbr.r <br />Proposed Uso ot Bwltlmg <br />DescripNon of Work lo Be Dono: <br />� �• � � �Q { <br />SIPIB�Z�P <br />SIOIP�ZIp <br />Phono <br />$lalclLp Pnon^_ <br />�o�«a�,�5�o,x� <br />Contact P�rson (Pian Rewew) <br />NOTE: WIRING IN NON-UWELLINGS IS I�E�UIRL•D TO �'EE I <br />E3E IN RAC[WAYS, MC OR AC C11BLE . GD � <br />/ � <br />CITY OF tVERETi LOCAL SALtS TAX CODH IS ]105 - -�- <br />1 hereG)' coRJy fhnf I hovo r�ad nnd oramined fhis app��caUon antl knowlhe Somo to be (ruo and <br />conecL All prov�s+ons of Inws ond urd%nancos govr,rnlnU fhis rype ol work wiU bo complofad � <br />�vho(hor spociLeU hornin or noL Thu gren6ny o! o pmrmt daos notp ��5umo fo 9ivo aufhority to O�i �O 3 <br />wnlafe o� cencol fho provisions ol ony ofhef Sfolo o� loCol law rogu%otu�q cons!roc(�on or th0 I� � <br />performancn o/wn:tn�cLon. Thot 1 am aufhonzad by Iho avnerOt th�s pruporty ta porform tho <br />woik Po� whrch appficohon is made and I comply wdh the Stafu Convacfors L�w 18.7.7 RCW �nd <br />:sc 20o wnc. <br />