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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-25 � -8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 0 AM TO 4 PM <br />'' � <br />��' � �-� ��l � � - ) 4 , <br />PROJECT ADDRESS <br />i <br />� <br />, . . � i•�� t„ <br />Ownr,r <br />Tenanl <br />( ?UWD� <br />Eleclrical Contrac�or <br />Sla�e Liconso Number <br />Pro�wsed Use ol Ouildiny <br />� � i/; ' �y `� <br />Mall AAdir,ss <br />61,u1 �ddre :s <br />Mail Address <br />�I�% � I/r_lii` <br />c�ry <br />Gly <br />Cdy <br />G�,� <br />Slale:Zip <br />Sla�r.2�p <br />S�alelZip <br />(1LL.' i(�(. i',L L `/'. <br />/�u.e- 1�:; � ,. - � ; O <br />%�'1�/ <br />Phone <br />Contract Price of Work <br />Conlacl Porson (Plan Reeiew) <br />i <br />Desr.riplionofWorktoBeDone�, %�:.�>�./�CC, Ij�W(1_, � 1��,�17L�� (�'���V�GL � %�)U�S Y/��-!CZ <br />NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO <br />F3[ IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cedily fhaf I have mad nnd ex�vrninod fh�s npplicaGon and hrw�v fhe sr ne to be bue end <br />conAct. All pmvisions ol Liws and orA�nancos governing Ihis fype o! H�ork will be ^cmplefed <br />whnthcn specilied herein or nof. The �ran6nc� o! n pernuf Aoes nof vesume fo grve authurity lo <br />vinlnle or concel the {vovisi�ns o/ nny other sfate or IocnUaw �enu�atin[� const�ucl�on or fhe <br />perfonnance o/ construcfion. Thaf 1 nm eufhorized by fhe owner of Ihis property fo per�orrn the <br />�vork !or �rhich opp6caGon is rnade and 1 compty with fiie Slafe Conhactors Law 18 27 RCW and <br />295 200 WAC. <br />FEE <br />� <br />r i�j� <br />r l � ' �� ) <br />Phnne <br />Phone <br />