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ELECTRICAL PF•RMIT APPLICATION <br />CITY OF EVERE7T PERMIT SERVICES <br />3200 CEDAR STllEET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />""-/%,%, , - '?' � � <br />J/ � , � -r � i I <br />i� > , l l� (._('i I I <br />PROJECT ADDRESS <br />Ownor <br />Tananl <br />Mall Addross <br />Mail Address <br />Clly <br />City <br />Stata/Zip <br />Slale/Zlp <br />rnooe <br />Phone <br />�� ] � " — , �( i � � rJ <br />I;�I::1��_h`( ��:-(i`�'��1� .;CIC 1 n J'��/� �-i /( �rlv ��A1'kS�� l,Vu `��j2(/ a�S.'�i7BlSy <br />FlocUical Conlraclor M11ail Addicss Clly Slatc/Zip Phone <br />� 1�li.�,A�'� l �I �/ �/��i.� � { ������� <br />Stato Licenso Numbcr , <br />���� � �, (,L <br />Proposc] Usc of �uilding <br />�' 11�V ' �/:- �/`, <br />Doscriptiun o1 Work to Dr. Donc: �_ _ _� �� <br />NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />f3E IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />. � �� <br />4".S C' � <br />Conhacl Pdco ol Work <br />Conlacl Porson (Plan Reviow) <br />1 hcioby renh�p fhaf 1 have renAand exnmi�mJ fhis npplrcnhon and hnow Ihe sr;me to bo fruo anA <br />conorf All pruvisions o/laws nnd orAin�nc��s porerninc� fhis fype ol �rork will b� complcrfed <br />whelhrr spc cdred ho�ein or nof. The granfing ul n permd dnes not �rasurnA fo give euthonty fo <br />�� uletr or cancel fhe I�rovisions al nny ofher state or lucal Inw regulatin� cunsfruclion or fho <br />perinnnance o! construefion. Thuf 1 nrn nufhonzed by the o�vner ol fhis property to poilumt the <br />worh !o� wh�r,h applicafion is n��de and 1 cornply wiih fhe Stnte Conhacfors Lmv fA.27 RCW and <br />?9G200 WAC. <br />, � � _ <br />�, <br />, . ' r''1 �l�(�c. < < <br />—�� �S��nnwrr Ua�T� <br />FEE <br />r �,c,.�-�ti3 <br />