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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 ACCEPTEO FROM 8 AM TO 4 PM <br />� � <br />..� . . , / j ! . .. / .� i <br />n' �- ✓ � �,' / .� / � , �'� �_� <br />PROJECT ADDRESS <br />n <br />�� � i i- <br />O�mcr <br />Tonanl <br />/.'/ .-+ I ��� <br />E�oclrical Conlraclur <br />Slale Licenso Nmnber <br />Propos�id Utic ol 13uddiny <br />f 1' /" : { — <br />Mail Ad ress Gp <br />Mail Address <br />r L <br />� � <br />A ail Address <br />Dascnpfon uf Wnrk ��� C1i� P��rn� _�.��� �'. C <br />r. <br />NUTE WIRING IN NON-0W[LLINGS IS R[�UIRED TO <br />BE IN Rl1C[WAl'S, A1C OR AC CA�LE <br />Clty <br />Cily <br />f i.✓ �� i'. i <br />St:tic%Zip <br />Slatn2ip <br />SIa1c�Zlp <br />Contracl Price of Work <br />Conlac. Person (Plan Revir�w) <br />CITY OF EV[RETT LOCAL SALES TAX CODE IS 3105 <br />1 hcrehy cmfil�- flmt ! hnve ruud and canrnined fhis npplic�ation and Fno�r fhe sarne fo be truc r+nd <br />�„neel. All prov�sinns o( la�ss and nidininces poveminy Ihis type o! work �rdl Ge complefed <br />��hefhcr sper.�lied hacin o� noL The qranfinq o/ a pernnt do�s nof �msunm fo c�ivc aufhori(} fo <br />ciolnte oi cancel the I�rovisions o� an}% olher stafe u� lo�nl la�s ro�u/i6nc� canstn�cfion or the <br />perfonnance of const�ucfion. That 1 t�m nulho�imd by the owner o! fhis property N p�rform fhe <br />�sork Por nliich npplica(ion is maAe onAl complp n•ifh tlic SWfe Conhacfors La�r 1 � 17 RCLY anJ <br />7')G.200 lh�'A C. <br />I' <br />i <br />- -- <br />� -- - - - <br />FEE <br />���_ ,� t <br />f- v <br />Phane <br />Phonc <br />r�,o�n, <br />