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ELECTRICAL F'ERMIT APPLICATION <br /> CITY OF EVERETT PERMI'i SERVICES <br /> 3200 CEDAR STREET, EV[RETi', WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everethva.org <br /> APPLICATIONS ARE ACCEPTF.D FROM 8 AM TO 4 PM <br /> ^ � <br /> � <br /> i , �� �,�L-i ��j��\\ ������ :��! � �� � �� <br /> PROJECT ADDRESS <br /> � , � � l ���Z��<>-iv _��t�.-1. <br /> , <br /> - ^'��\�, ` �.'�'_.' � � ,. � ,.� ;_�,_�,:, �.� � ,_� , � <br /> Ownef �dail Addross Cily Slate2ip Phone <br /> Tenanl Mail Address Cily State/Zip Pheno <br /> � <br /> `��\ �_A-������� G��-�t'�C C�_> ��L. �+_��+� Z�,� - !�`5`i=� <br /> Electrical Contractor T Rtail Address l city StateRip �hone <br /> ',\,\� ,��1=,�v����' ; 1J_ 1 -- - <br /> S ate License Number " Canlrar.t Price o(lVor4: <br /> Proposed Usr o(Buildinp Contacl Person (Plan Review) <br /> Doscrip�ion a�Work ln�o Uono: ���,J\`�`C_+ �'� �, j >�� � I I `–' `'' <br /> NOTF: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAI'S, IviC OR AC CADLE. 1. , <br /> �`� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 heroby cerlily liiat!fmve ro�id e�ad examinod this applice�tiun and kno�r fhe sarne to be true and <br /> COI/L'CL AII(]fO19510fIS OI IetYS il/i(I 0!(Iltl:lllGCS gJVPR7171(f}IIIS I}�pe of�ti�ork u�il1 be completed <br /> �rhether speci�md herein or noL Tlm�rantinp ol n pernut does not �resume to giee authonty to <br /> ��iolafe or cance/fh�provisions ol an}�other state or locaf l��r rogul�tinp consfruction orthe <br /> perfonnance o/construction. That 1 am euthorir.ed by fhe o�sner o(this p�opert}�to pedomi the <br /> n�ork lor n�hich applicatiun is mfide and 1 comply�viflr the Stafe Cenlractors Law 18.27 RCl4�and ^ <br /> 296.2001VAC. j/ i <br /> . �, ; ��- � /—'�� �� j � � 1..` � %�� � /1�� <br /> �1 ' �, <br /> Srn;lwc ' � ' Dafo� ' � ��� <br /> � % ��l <br /> �I1, <br /> V <br />