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ELECTRICAL PERlVIIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, VVA 98201 <br />425-257-8f310 - FAX 425-257-8857 — www.evr.rettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />— r-�-����� , l/� _SCi�i.. ��c�S � � 1�.. <br />. � � <br />�-; 7� 7 / S 9 f" �r, S t. �:�z,.�-�,,,� l lc�,% '' <br />PROJECT ADDRESS <br />/ — -- <br />� <br />� �,r/ � G �� <br />' , _� �r: // . )�� �� � � � d� ST ��:s+rv�/ �LiY- %��� <br />Owner Mail Address City Statc2ip Ptonr� <br />Ten��ni <br />�1ail Atldmss <br />Cily <br />Slate/Zip <br />Pho^ � <br />�1 " ' <br />- �c�/, � --- �l `-_ ''`'' J' � / _J -- <br />EIoClricalConlrar.lor 1.1ailAdtlress City Slalc2ip Phonr <br />Slilc Lir.��nso Numbcr <br />Propased Usc ol Ouildmp <br />Descriplion o( Work lo Be Duno: �r s KC� I�. fi � e. (� <br />�^/� _ S'�rt..�. , ��.s -� <br />NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABIE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />�r�, . � <br />Conlracl Price o1 Work <br />Contacl Person (Plan Review) <br />�iru..,f �+- /�< ts,'i': <br />1 hemby r.crtdy lhaf ! h�v�� �ot�d nnd ceanuned fhis aoplicah��n nnd Ano�r fhe sarno fo be hu� and <br />�.nnecf AU nruvisions o! Imrs nnd orAinances guvenung fhis typo ol �ivrk �vdl be cornpleted <br />„helhor sprohed herem or noL The c�ranting o! a permd does not vesunre lo �ive �ufhonfy (o <br />� mlafe or cancellhe provisions o/ any ofher sfala or local l��r mgulttirtg const�uc6un or fhe <br />p��Arnniance ol const�ur,fion. Thaf 1 am airthonz�d by Ihe o�vner ol fhis picperty fo perlorm fhe <br />worA lor �rhir.h applica6on rs made and 1 comply �vRh fhe Sfate Contractors Law 18.27 RCW and <br />ZP5.200 WAC. <br />� <br />FEE <br />/' � -7 � <br />r'� ��, <br />