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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 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />/ :�c� � ��y �� P� �� <br />PROJECT ADDRESS <br />.1 � � 'S^�-�1�(L; S'/�nZ:� <br />Owner hlail Addre��s Cny SIa1c/Zip Phone <br />.���i <br />Tun�n� hlail Address Cdy tilale'Zip Plwne <br />E-"!2G �LFx_ �S'7-Z (�<<�h �vc �S ��2- G—v��.4( (N�� j ('�/ <br />[leclrical Contractor nta�i nddress Cuy Slaic2�u Phone <br />� <br />� %Z� L C� r'.� �,v� DcU � ,�Ol1U -- <br />State License Numb��r Contracl Pnce o Work <br />� �'� f� �U l� <br />Propused Use nl Buildinq Contar.l Person (Plan Review) <br />J <br />Doscnption ol Work �o f3c Dune�. �c t <br />�C � � �� _ f /.L' <br />>� i1aq�� Fr�,� �-� l�ynds <br />NOTE: WIRING IN NON-DWELLINGS IS R[QUIRED TO <br />BE IN R�CEWAYS. MC OR AC CA6L[. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hi�rrh�� r.��rtily lh�rt I h;�vc re,�d nnJ raarnuied Ih�s opphcahon nnd 6no�r fhe snrne fo bi• frue onA <br />conrr.( All prowsn�ns ul Imss nnJ urJinancrs govenung Ihis tpPe ol �ror6 �sdl be corttplefed <br />�shethri spcahrd hcrom or not Thc c7r�mhnr� o� n perrnR docs nut uesumo fn �ive riud�onty lo <br />violate rn cancel fhe novisions o! nny%olher sf�te or local law regu�ifin� consf ucfion or the <br />perlorm;�nce u! cuns�rucbon. 17��t 1 am aulfrunred by Ihe owner ol fhis p�operty fo perfonn fhe <br />IYOIN IOI l4'IIICII 7jJ�)IIC7ilOfi IS 111.71IC illl(� I COlil/)I}' 15YII1 iI1C Slafe Cnnhacfors Law 18.27 RCW nnd <br />29G Z00 WAC. <br />/�i'��j. ��' I <br />B le <br />FEE <br />�� � (,ltt � l) �% � <br />