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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982_01 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /��� � ( � <br /> (. C�� lJ� ;i�`\\ � ^ \ �� `� � �� �J <br /> �� � <br /> PROJECT ADDRESS <br /> .�� ` � , i � ��� �� � ._ '�'� � <br /> ` - `l L, � � <br /> �. �;���L�.�U'; i��.v � ;v`�C� u��i �., � 1 - -, `',1- <br /> Owner Maii Address Ciry State2ip Phonc <br /> Tenanl Mail Address City Stale2ip Phonc <br /> �,��;��_�'I� ��.���� {.�L�' � � � W ��'( \L• �U�'�� �.�'��. - �� � �t <br /> [leclrical Cantreclor Mail AdAress City Sta�elzp phone <br /> 1 � <br /> ` \�� � :A L���. � -�� � � <br /> S ale t_icense Numher ' ' Contract Price of Wurk <br /> Proposed Use oi�uildinc� Con,acl Person (Plan Revierv) <br /> Doscriplion of WorA lo�o Dona ���J\\'�`C� �'�l� u ') �� � ���--- __— — <br /> _�— <br /> NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAI'S, MC OR AC CABL[. � <br /> CITY Of EVERETT LOCAL SALES TAk CODE IS 3105 <br /> !hemhy ro�iil}�tf7at 1 h;rve read a�id exnmined fhis applic.ifion and kno�r the same to be truo and <br /> corrucf. All pruvisions o(latrs nnd ortfinances goveming fhis f};oe oI�vork�rill be complefed <br /> �rhetherspeci6ed heroin arnoL The�ranlin�e/a pertnd does not/�resume to gice aufhenfy le <br /> violafe or cancel tfte provisions ol an}�other sf.�te or local law reguln(inc�construcfion or fhe <br /> pedomiance olconst�ucfiort. Thaf I am autftonzed by the o�rner olfhis preperty to perfonn fhe <br /> �vork Inr which application is made and 1 r,omply nifh the S(ate Conlractors Lmv 18.27 RClNand <br />� 29G.200 41�AC. <br /> / �' � –� �• i:� / <br /> -����..��� ,;. ,-��� �-I - I - � , �2.�� <br /> ' q. Siona�ure - �atel � � <br /> / '� <br /> ��I <br />