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ELECTi�ICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 - w�vw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM g�71—D� <br /> � ' 6=0�0�-�5 S <br /> � , � <br /> � ' ' . > ,r ,� <br /> P�CT ADDRESS <br /> ! ,� , <br /> Ownc� A1atl Addross Gly State%Zqr Phono <br /> ____.. _ ___ ___ .. . <br /> Tenan� �.f.oi,^,�f�f���>; t'.�i, tii�i��Z�p F'no�,e <br /> t _ t����'- ' <br /> Elocirical Conlracbn r.r�d���fn�o�.> - - ----�:r.,; -- -�- tiia��Lp i'ncur <br /> Slale License Numl��v Contraet Priee of Work <br /> S ;� . <br /> �� ��-. - <br /> Proposod Uso ol Duildinq Contact Person (P�an Revicw) <br /> Desr.riplion o1 Work lo Oc Oone: ��- �� � � r'- �'' l �� � � �� �='�"�-�—+" <br /> , <br /> NOTE: WIRING �N NON-DW[LLINGS IS R[QUIRED TO FEE <br /> BE IN RACEWAYS. A1C OR AC CAE3LE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> 1 6oirbr ror6l}�Ihnt 1 have«�ad and r.nnunod fhis upplca6on;�nJ know th�� sonu�fo bc Luc and <br /> ronrrl� All provisions a!la�rs �ind oidm.�nrrs uc��vning flus fppc ol����rh nvll bu canplcled <br /> whcfhor speahed hercin oi not !hc p��+nfuig el a pernirt drn�s nof ��osurni= to give�aufhonty fo <br /> � v�olale or.:ancel lhe �rovrsints O!any ofhui sfnfa or loral Imv ra�u��Nn�ionstrudion or fhe <br /> perlormanc e o(cons��ucfior That 1 arn nufhoiireAbp the o�rner o�fhis p�operiy fu p��iorrn Ihe <br /> work !oi�rhich npplica6on�s rnade and I r.orrplp u�ith fhe Sfale Conharfors La�r 1 P 27 RCW and <br /> 296.200 WAC. <br /> �_.. _ �� ;L. < <� -- <br /> Signalure Ualc <br /> y` �. 7 CI K" � J � <br />