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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES g_ig_�� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-P��10 - FAX 425-257-8857 - www.everettwa.org �Og() �-0 ��j <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />~ �� ��� S , �; Lo� /� <br />PROJECT ADDRESS <br />� c' � ��%1/% <br />�—, <br />ownur <br />Ten�nl <br />�-l� r � S !� /J��� � <br />Elocirical CoNrar.tor <br />hlail Address <br />Mail Address <br />61ai1 Address <br />c��; ,- k � ���, ��.� <br />St�tlo Licnnse Numbcr / <br />��r'c�) �/C�1j C'� <br />Proposr,d Ucc ul Ouildmg <br />Dasr.riplion ul Work tu De Dono: <br />NOT[ WIRING IN NON-DW[LLINGS IS REOUIRED TO <br />BE IN Rl1C�WAYS, MC OR AC CABL[ <br />City <br />l;ily <br />� <br />� N <br />Cdy <br />�i <br />Slale/Zip <br />Phone <br />Statc/Zip Phone <br />;' S���a►��� l �z� z <br />state2ip rhone <br />� <br />s ��. -- <br />Cnnlrrirl l'ncc u� Wi�rL <br />Conlar.t Persnn (f'I�in Ruvie;:) <br />CIl-Y OF EVERETT LOCAL SALES TAX CODE IS �105 <br />I hombt ��� ��hl} Ih,d I han� mnJ and rtemrnod this npp6cnhun nnd Fnow fhe s�nre fo be fnie and <br />r� �nrrt. �I mo-�v, �ns nl Ida�s �ind orJ�n.�nc� s go��o�nui�� fhis type ol woik will be cornplefrsd <br />�ch�Yl+��r spe< ird hric�n oi nut The ��anirng o! q pnnnd Aoes not pfC511/il(i iJ (JIV@ HIIIII0I1�}' i0 <br />c�olafe ur c.im �,�1 fhr /�iovisions oly� iy ,�hor state or Incel lew regvinhng corrstn�r.6on or tho <br />p��jornr.�nce r consfrurborL Tlr,�tp i aufhonzed hy fh� owner o! flris property fo perlonn fhe <br />wo�A loi whicl npplq'ahrn,r6 pn�(1� d I cornPty with the Sfnfe Conlraclors Law 18.27 RCW and <br />�, f /�/' <br />s��;��:�h��,� <br />�, <br />��/� zrx� �' <br />FEE <br />^ , % �� �. <br />,. <br />L '� <br />