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ELECTRIC�►L PERMIT APPLICATION <br />CITY G� EVERETT PERMIT SERVICES <br />t200 CEDAR STREET, EVERETT, WA 98201 <br />425-25'-8? 10 - FAX 425-257-8857 -- �vww.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO d PM - DEBIT U CREDIT CARDS ARF NOT ACCEPTED <br />4 — <br />� �3 ir" 1%,� ���i S_���� -� <br />.� <br />PROJECT ADG �ESS ���.� <br />, � � <br />—��� I ��A� C�� /Fi Y/�� C(%C I�F' �•Ar�l t,`�" � 4l �' �U � b <br />I�)wnor Matl Address City Statr��Zip Phone <br />T�nant <br />Mail Au�re9s <br />�� ),�,�r�ti� (�ui� �-�c -� c <br />F��rical ConUactor Mail Add�ess <br />�,�, c� ��-� �r ✓ � — <br />St,�te Licensr Numbi�r <br />Propnsnd Use o� flutl�iuiq —_� <br />� <br />City <br />Slale2ip <br />City ( Stale2ip ^ <br />/! <br />Cantracl P{i e o1 Work <br />Description of Work lo Be Done: I�� bl �. <br />NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3105 <br />Contacl Porson (Plar Review) <br />I heieb�� certily thel I hnve ieeAand exNnrmed Ihis npplicnhun anA k�iow the sanre fo be true and <br />r.orrecl. All prowsrorrs ol laws and oreLnances )ovemmg this fype ol work wdl be corrrple(ed <br />whefher specdred herem or nol T�ir �ranfrny ul a p�rmd does nof presume fo groe aufhonty fo <br />violate or cnncel tbe provisions o, ry o'her sfafe er locnllaw reguleUng r,onshuction or the <br />peAo�mance ol corrsfrur,fion T f/ anr a�.Y�onzetl by fhe owner ol �his property !o perl-rm fhe <br />work lo� whiclr opp�aUnn is ade and I comply wifh fhe State Confracfers Law 1A.27 RCW and <br />2J6.200 WAC. / <br />� ro - <br />FEE <br />; — <br />r-�����-��� <br />Phone <br />� �Jr <br />�,� i 1� <br />� -no�a <br />�� <br />