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� � <br /> ELECTFtICAL PERIVIIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, VVA 98201 <br /> 425-257-8810 - FAX425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 0 AM TO 4 PM <br /> r� ��Z ��3 <br /> � ��a a. 5 � �� �� � r �,��,_�� <br /> PROJECT AODRESS <br /> �J1-—`.�,��'��.(,�..r �� � c`� � '� I �'� �� S� �� � � ��a � o�l 2 <br /> OwnCf� Mail AOtlrCc� Gty $Iote/ZiU Phonc <br /> Tenanl A1allAddr�,5 Cily Sla�er7.ip Phone <br /> `�su�.� ' -� ,� �4��o � ���I�h �� `���It L�,'�� � �:I . �� <br /> EloctricalContractor .ti�e��hddress City SlalelZi (� <br /> � �� ' �y CJ• PhpnC <br /> �� �.�-- ��CQ -�-� c� <br /> Sta1c License Number .,onMJCt Price of Work <br /> �� ����� <br /> Propo,Cd Use o uil�ing Contact Person (Plon Rewew) <br /> De3frip6on of Woik t0�e Donc ,��yl� ` '�-Q� � <br /> -- � v ti�_ <br /> NOTE. WIflING IN NON-DWELLINGS IS REQUIREp T'O FEE <br /> DE IN RACGWAYS, MC OR AC CABLE. �Ov� <br /> CITY OF FVFRETT LOCAL SALES TAX CODE IS 3'105 � <br /> �nereUy certrty fhaf I navr, r�ad and exnm�ncd this apphwflon nnJ kno��i�Itc sarnB 10 bo frve nnd <br /> corB:f. !1/1 p�ovi5iUn5 011aws dnd Orc1ir1�nC05 gOVMning t{iib lypo ol�vC�k wrll be cOmplplCd �I � � <br /> whppicr 5peahe0 hCrein or noL The r�ranfinq oln permit doo^nof presumr�tu give uu(henty fo , I " 0�� <br /> violalc or r.ancnl fNP Prov�son,;0(eny o1hc�5fe7e or/oC7ll�w rPgu/nhng con.,fruchon or lhe � <br /> per/o�monr,r. o)cnn::.rucdon Tha!7 am nufhonaetl by fhe ou�ner o/fhis propNriy fo po,-foim IHa <br /> wo (or whrch apphwlion is�narlc.�nd r eomply wirn the S�nto Confrecr�rs Cav+ fA.27 RCW antl <br /> v . UWAC <br /> �� -���1�� �� 1 I � <br /> � Signaturc "— o�,�,-�� ___ <br />