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{ . <br /> ELECTRICAL PERMIT APPLICATION <br /> CiTY OF EVERETT PERMIT SERVICES �b�a 3�Og <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 42�257-8857—www.everettwa.org �D$l D—l�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> �L l a -�h ,�r �r� ��e�� 9 ���/ <br /> PROJECT ADDRESS <br /> .v� i-vt l (.��h �1�e.�'c�'-� . <br /> Ovmer Ma�iaedress cay s�aeerrp Pnone <br /> Tenant Matiaderese Cny State2ip Pnone � <br /> sh oh�� <br /> ��-w �.� �re�-, � ��% � � �l.caa � �s� ��. � <br /> Elethic�l Conhacfor Mad Addrecs City StateJZip Phone � <br /> -�YWiN �.I� °I � 3� /� oo <br /> Siate Liccnse Number Cont ct Price of Wak <br /> Proposed Use of Buiiding Contad Person (Plan Review) <br /> Qexrip6on of Work to Be Done: tt .'_I j/I il� � ��.---T�G��� � " �� �j ����7 <br /> � ff _ <br /> Y ���L���� � �� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />' BE W RACEWAYS, MC OR AC CABLE, <br /> CITY OF EVERETT 40CAL SALES TAX CODE IS 3105 <br /> �hereb certily that 1 have read and examined this applicarim and Imow the same to be hue and <br /> wh���s�p�ecirofied�herein o W�ot�The q�ranhng o�f peimrt doe�otprs�me�to grv�e auth�ty to <br /> vio!afo or c�ncel Nra Provisions of any other sFate orlxa!/aw repu/atlng conshvctio�or�e <br /> perfamance ofcons(rucHon, 7'hat I am auMiorized by[he ownero(th�s properfy to perfam�Ihe <br /> work(a�which application rs ma[le and l comply wlth the SYate Cafhacl�rs Lew 18.27 RCW and <br /> p6.200 WAC. <br /> lgnatu�e DaW <br /> ?/r - /� �' <br />