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ELECTRICAL PERIVIIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �__� O� <br />3200 CEDAR STREET, EVERETT, WA 9f3201 <br />425•257-8810 - FAX 4"5-257-8857 - www.everettwa.org �[�8�g—(� a <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />(o�-� l � �c / S � , <br />PROJECT ADDRESS <br />�GS� i��� <br />oW��� <br />T OI1�I11 <br />Mail AdArr�ss <br />--� <br />Mail AAo�ess <br />r�%, 7.3/ <br />f_ladrical Conlrar.tor Mail Address <br />�ylc,.k ETC � %�- �' <br />Slato Llr.ense Numbor <br />P�oposr.A Us� of Building <br />/--� ���'D <br />City <br />C;d�. <br />�S�s� . ,lJ c�J <br />(:ily — <br />Slaleilip <br />SIa1NZlp <br />{G.�ltJeo�%�*%� <br />Phonc <br />�R4L:7 <br />SlaleZp Phonc <br />_��__.. <br />Conlract Prir,e of Woik <br />CoNac� Pcrson (Plan Revir.w) <br />/ i <br />Desr.ription ol Work lo Oo Done: (�� .' / ��%%� �� Nt �'J �(,vt'(—� (f [�- <br />NOTE WfRING IN NON-1�11�[LLINGS IS R[UUIRED TO <br />BF M RACf34�A1'S. A1C Of2 AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hi �eby r,er6ly lhnf I hnv�� rr �id �ind �°x,urunrJ Ihc, apph� alron and kno��� fhi, s,�me fo ba fn�e and <br />�� necf AO prowsrons oll �ws nnd o�dm,inces yovern�ny llus type af work n�ill bn rrornplefod <br />�tli� fhr�r specJi�rl hpip�n or not The y�an6np ol a pennd does nol irnsurnc. lo �it�a nu(hordy G� <br />� �, Jafu nr,ClftRl the I�rcnsions ��l;iny ofher state or lucal low repulilin� ronsfn�cGon rn fhe <br />prilonn;mcr ol �onsfruchun rhat !�mr auNi �n: ed b}� Ihe awnar ol fhis properiy tc pe�fo�m fhc� <br />n�uk lrn �rhich a�plineGon 7s rnaJr anAlF'�PI�, wilh fho Strrt[� Contraclors Lew 1d 27 RCW anJ <br />.'l.,� ;�i10 Lh'AC. � �,� �i <br />i � <br />/ i �'�/ � � <br />_ � � � -�`� /� ��.i �%L7� <br />�_ ._ <br />siannli m Datc <br />� <br />FEE � <br />C�}��� � �`�3 <br />