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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />320Q CEDAR STREEl . EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - wvwv.everetiwa.org <br />APPLICATIONS ARE ACCEPTE� FROM 8 AM TO 4 PM - DEBIT 8 I:REDI; CARDS ARE NOT ACCEPTED <br />�3 � � 1� � ��'� �l_I_�_ Y� �, <br />PROJECT ADDRESS <br />,, ` 1,j,�/ <br />� -` ` . <br />� ��� '�;�J � Jl %�/ Sz `z.�x <br />S n : r \,U tii� �. <br />nwner Mau Address <br />7enant <br />����� <br />�ICG1/1C8� i;OfllfaClOf <br />Mail Address <br />�,�.:.G't <br />� <br />�re�'IS ✓ � <br />, _ <br />Slate L r,ense Num6er <br />PrnposeA Use ol Buildi�g <br />Descriptian of Work io Be Done: <br />Mail Address <br />Cily <br />Clty <br />Gty <br />Sla�eiZip <br />Stale/dp <br />G W� <br />SlateiZip <br />`� r� �70 %C •'� <br />Phone <br />Phone <br />��� l � ��as� 3�? <br />Contract Pr' e of Work <br />Contact Person (Plan Review) <br />��'i�. � f�C _ � � — <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RAC FIVAYS. MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX COJE IS 3105 <br />I herebVi cerLlp fhaf I harr, �e��d anJ P�,vmnerl fhis applir.ahon end know the sarrre to be f�ue and <br />�;orrecf. All provivens ol iaws and ordmances goverruny th�s type of woin wdl be cornpleled <br />whefher specdicd herem or nnt he gramrny ol a permd does nof �rr�sunie to give aufhonty fo <br />v��;rite r,r cancel the provisi ns ol dny ufher stale o� local law regu�alinp cons'�ud�on or f.bN <br />p..n�vmance cl consVuc( � T t 1 em aufhor¢ed by fhe owner o! fhis propen� fo peAorrn Ihe <br />.�. �F �, r wh�r;h a�Pbca n is de end I comply wRh the Stafe Confracfors Law �8.27 RCW onA <br />;'00 WAC. . <br />� _ �. ��' ��, <br />��_-�-- <br />FEE <br />r_=����k-�� ,�,� <br />