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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICE5 <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-2��7-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPT! D FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />��\ <br />PROJECT ADDRESS <br />Ownor <br />Tenant <br />Mail Address <br />Mail Address <br />Conlractor Mail Address <br />1 111�C 1`( �(- S��1� L>���- <br />Stato LicAnso Number <br />Proposed Uso ol �uildin9 <br />Description of Work lo �e Dono: <br />UC' <br />� =. <br />��,� AM9., � <br />NOTE: WIf21NG IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />Qly <br />City <br />t <br />Slate'Zip <br />Slalcilip <br />Phnnc <br />F'hone <br />Z,���l 35v - <br />Phonc <br />� x'k'>, O C� <br />Contract Price ol Work <br />Conlar,� Person (�'lan Rr.vicv+) <br />��\ IrY-� �. <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS �705 <br />I heroby cerfily Ihaf 1 I:avc rcad and e� nnmrrd fNs app0�a6un and Anow fhn sum� fo Ge Vue anA <br />conecl. All provisio��s ollaws nnd ordm,tnces guvernin� this fype o! work will be complefed <br />whefher spec�bnd hr�ein or noL The pranhng u! n pe�nul cioes nof prFsurne fo gi✓e nulhoriry fo <br />violate or c�ncel fhe provisions o! nny �.>ther stafe or local law regulafing construifion or Ilre <br />performance o/ consVucfion. Thet I �m autho�ized Gy fhe owne� o! fhis prope�ty fo prrlorrn the <br />wo�k lor whir.h npp6r.aliun is mnde Flnd I comply wifh fhe Sfnte Confrecto�s Law 1 A 17 RCIN and <br />296.200 WAC. <br />` <br />� — /� � I _� - <br />_� l; ~ .� � •� <br />