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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, VVA 98201 <br /> 425-257-8810 - FAX 425-2.57-8857 —www.everetM;a.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> l � .� j/� =� F� .s � ,��f � <br /> P OJE�RESS <br /> � p <br /> i � <br /> _ � r �/� � c, -i � n ht ��,c!- �� ( o �'. <br /> Owner Mail ACAress City Slate/Zip Phone <br /> Tenant Mail Address City StateiZip Phone <br /> 1_�C' // c __i� / . <br /> 1�r_L7 ._�i1 ��l.._�i/T�„t_/�_...L-�L} r' . <br /> Elwclnr.:tl Conirnctur �� �,I;ul nn,tw��r�, C,ly Slate-Zip Phone <br /> S�a;��Lir_ense Nunibi�r Contiact Price ol'Nork <br /> P«�pased Use ol Bwidm9 Contact Person (Plan Review) <br /> Ucscriphun uf Wurh �u f3e 1J�7nn�. l-�� I"�T_ ��! � ��b m L', <br /> NOTE. WIRING IN NON-DWELLINGS IS REDUIRED TO FEE <br /> BE IN RACE4VAYS, MC OR AC CABLE <br /> � GTY OF EVERETT LOCAL SALES TA% CODE IS J105 <br /> � 1 hw��hV i crtilY fhaf�hat�e ie3�1 am1 �narmneJ 'his dpph;dncn,�rrd hn,;w fhe 5ama to be frue dnd � (��j(��� - (-� 4 <br /> �:,)necL All provisions ol ia�+_s dn�i .v0inances ]ovemmg fh�,s {�pe�l wcrk wdl be complefed <br /> whether spea6ecl��erein oi not T'he grantmg o�a permd�Yces nof resume to g���e authonry to <br /> woiate or carrce� the prowsions e/ony other s�afe or lnca�iaw�r,guP6ng construc6on or the <br /> OeAermance ot;�ns(rucl�on. Thaf I am au(hovzeA by fhe owne�ot fhis U�operty to peAcrm the � <br /> iv,,ra !cr�an�ch appbcat�on is made and I comp�y wRh the State Ccnrractcrs�aw �8 27 RCW end <br /> �90 .'�tJ vVAC. <br /> � I <br /> � <br /> �'. i � ���. ��� � � <br /> _—a;i,ynaluie � � �ate <br /> I _____ <br />