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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 96201 <br />42�-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />1 -- '- ' � �� S / � �- <br />,� <br />�" � <br />; , r ; , ,�✓•; S L• �3 ;> < c��j, <br />PROJECT ADDRESS <br />�; �.; �� �� <br />, r�. �" , -: � / ��J- � � t <br />�� %f� j � t�- i l � i � 7<." /;� �t �.1 �; L f <br />.'� � �� -- <br />----- ------ -- ---- Cd Stale/Zip Phone <br />Owncr At,d �ddre�s > �O �� � 1%! 1. J� <br />Tenanl ---- --�- <br />(,l l-.,' i l P � <br />Eledrical Conlractor <br />Slale Lic�nso Numbcr <br />�1all �d,fio::s <br />A1all Addicss <br />— � GI�. <br />Clry <br />Propas��d Usc ol �uildinq <br />' j'��. <br />r �,1� 1�\r��•' ✓ � M��«� <br />Dnsai{�Ii��niill�urV.l��l.�.l_m�� __ __'_. • <br />� �� 7 � 1 � . � � r 1 � ��i � f:� �('� / G �i <br />NOT[: WIRIN� IN NON-D�V[LLINGS IS RE�UIR[D TO <br />OE W RACEVJAYS, A1C OR AC CA�LE. <br />StatNZip <br />Slale2lp <br />Cnntrad Prico ol Work <br />Conlart Person (Plan Rovie•.v) <br />-�'✓. ,., Sy <br />CITY OF EVERETT LOCAL SAI.CS TAX COUE IS 3105 <br />I l;e�eby cnrtity fh��f I hace road anA exnmined Ihis applir,nfion nnd Fno�r Ihe snmo fo bo 6ue nnd <br />r.enocf AI' pronsions o(larvs and ordinanc�s yovernmc� fhis fypo o/ �sork �rill ba completed <br />n-hefhe� specilied heiein or not Tho ����nlinp o( n pernuf doos not I�rosumo fo c�iro aufhority fo <br />violalr. er cancel fhe /�rovisions o/ any ofhor slnte or lecal la�v rec�ulefing consfruclion oi tho <br />perlormmtco o/ constiuction. That I am aufherized L}� fhe o�vner ol this properiy fo pedorrn fhe <br />nork !nr �shich app�icafion is made and I comply with f0e Sfate Conhactors Lo�v 18.27 RCW end <br />?9(i200 WAC. -- <br />� , , _� <br />!/Z�l( 1� <br />�_ _.. <br />„��,.n� . <br />Phona <br />Phon^_ <br />iEE <br />� IL��r c��� <br />