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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 -�v�vw.everettwa.org �� —? j-L� j� <br />APPLICATIONS AFE ACCEPTED FROM 8 AM TO 4 PM �=G� 7��d L� -�'C � <br />° r, _,.! i► .� <br />.� ,�.. <br />, , <br />o�•�„<:� <br />Tenant <br />[ICClrical <br />fd:ul Addre_,s <br />I.tad!•,fd��.�..; <br />A1;W Fd�uc5s <br />l�� Nr� � 1�' � Ol �� �Jl/ <br />Slale License N imbr�r <br />a��Prf� o� avt s F 2 <br />Propoacd Use ol [?uddmg <br />Descriplion o� Worh lu E3e Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIR[D TO <br />BE IN RAC6WAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Ci�� <br />Cdy <br />� �a 4'o s <br />�,�,. <br />Stalc/Zip <br />r�����,� <br />SI:�Ie;Lp Iy �� � Phone <br />a WR ,�F'�p� �9-� y`< <br />S�a�e�Zip Phone <br />Contract Price of Worh <br />Ccnt:u:t Pcrsun �I'fan R�,�.iev;) <br />1 hemhy certity that I have read and examined this app6caGon and kno�r the sanre fo Le Vue and <br />conecf. All provisions o/ laws and orAinances yoverning this fype ol work will be cernpleted <br />whether specdieAhcrein or not 7he �ran6ng ol a pernut docs nof presume fo give authorty to <br />violale nr cancel fhe I�rovisions ol any other sfate or Iecnl la�r regulating cons6ucfien or tl�e <br />performance oI construction. That ! am authoiized by the o�ti�ner o( fhis property fo perform fhe <br />woik lor which application is made and I corr�ply ivth the Slafe Confrocfn�s Law f8.27 RCW and <br />zsr zou �vnc. <br />FEE <br />� �- �. <br />� �� � � � i �; �. <br />( ! _ . <br />