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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ��jC--G � <br /> 42�257-8810 - FAX 425-257-8857—wwW.evereitwa.org <br /> �� � ��,�_ .��,n <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT a CREo1T CAR�S ARE NOT ACCEP7ED <br /> a3� nrr�� sfi�vt- �i ����� <br /> PROJECT ADDRESS <br /> �"i"crr��'d f�t(�v�S 22�� p�' �t- ��/�U-Uifi w� �f��Gl a� �155 �rr� ► <br /> O�vner Mail Pddress Ciy State2ip ahone <br /> � <br /> TenaM MaitAddre�ss City State2ip PAone <br /> �Y�tiT�'1 �I PG�V�'L ��� NId�Lrl��!L��ZL SI`�ihrtmi5i� �� �, �0 �fT 3�'] o� <br /> Electrical C�or Ma1 Address City StdtrlLip PhonC <br /> ri��1V����i � f�� �y�`'-f� '� •�)� <br /> S'tate Ucense Number Contract price of Work <br /> ��/1'�1 �t `�I,n : �I�•3�`l. G��1 <br /> Proposed Uso of Buiiding ConWct Person (Plan Review) <br /> Description of Work to Be Done: �L(.��Gt C.�l ZC>0�r��n� ��r n.t l • <br /> ' ci <br /> �O � ZO° <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> DE IN RACEWAYS, MC OR AC CABLE. �� C'U <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I her�6y certify that 1 have read and exemined Urls applicat�on and(mav the same to be true and <br /> cerrect. N!provis/0ns o/fows and orcfinnnce>go�,r.ming Mis rype olwo7k wri!ba complefed <br /> wnethor�ecifred herein or not. The gn,nfing of a pemirt does not presume to give authalty to <br /> violafe tr canc�/the provis)Cns ol any other state a local law regulafing consfnrction orlhe <br /> peNamance ofconsfiicn'on. 7hat 1 am authatzed by fhe rnmer o1 fhls properry ro peAam the <br /> woAc lor which applkahrn is mnde and!cbmpfy with tha State Conhac7us Law i8.17 RCW and <br /> x�c.zao <br /> / �� <br /> y tur Date <br />