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ELECTRI(;AL PERMIT APPLICATION <br />�ITY OF EVERETT PERMIT SERVICES <br />3�00 CEDAR STREET, E\�ERETT, WA 98201 <br />425-257-8810 - FA1; 425-257-3857 - www everetiwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - Dt811" & CREDIT CARDS ARE NOT ACCEPTED <br />_1.����� �_9 ' � ��5�� � <br />PROJECT ADOhcSS <br />� <br />% 1 <br />�� t �J..,,�.��,��s a��!'/.sf �.�N �4 9�� �� g�� , <br />Owner ldall Address Ciry StateiZip Phonr. <br />f�nant <br />Mail Adtlress <br />�).�1�1�,�� � � il�,� ��g�� I �$� <br />Fleclric�l Conlrar,lor Matl Address <br />, , n. , � %�� � <br />Slate License Number <br />Proposed Use or Building <br />�__ <br />Descriplian of Work to Be Dona: �E � <br />NCTE W IRING IN NON-DN,'ELLINGS IS REOUIRED TO <br />BE IN RACElVAYS, MC OR AC CABLF. <br />C'. fY OF EVERETT LOCAL �ALES TaX CODE IS 370� <br />l:ity <br />Cily <br />Slate�Zip <br />Slale/Zip <br />� <br />Contrac� ice ol Work <br />Conlacl Pnrson (Plan Review) <br />I nemb�� ��erhlr fha! I fre� c� �ead and ,�x�imured Ihis epolic.3Gon and know the same lo be (rue nnd <br />r�ner( All provisions ul laws and o�d�nanr,es govermng ffus type ol work wdl be complefed <br />whethe. spec�lied herem or nol �he gran6ny ol a pe•mrt does nol vesume to grve aufhonty to <br />wolete or canr.el fhe provision 1 qny ofher stafe or locdl la�a ,�pula�ing r,onsfrucfion or the <br />wrAurmer;ce o! consfru Iron Iret I arn aulhontetl by fhe nwnF,r oI fhis praperty to peAorm fhe <br />ork lar whir,h appl�c on i inade and I cnrnply wrfh fhe Sfnfe ConUar.fo�s Law 1827 RCW and <br />2J�i.700 WAC. , <br />��_ ��.. . G' /C �i�^�� <br />FEE <br />Phone <br />Phone <br />' ,I1, <br />i �,' ��c'� �, 1 <br />