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ELECTRICAL PERMIT APPLICATIf�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />�f��-2�7-8810 - FAX 4?.5-257-8857 — www everetiwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� � �_ <br />—� � ' �— <br />PROJECT ADDRESS <br />, / �7,,/ <br />� _,� �; i �- l.�i � V �� iJc:� t'�I _ �� �i7�-^ � �S� <br />OWnLr Mail Address Cny Slale/Zip Pnone <br />�, <br />,�xJ�)�,C �V `rcTl lZ� __ <br />Sla�o Lir.r,nsc Number <br />) <br />I'roposecl(Us� ol Huili inq <br />Descriplion o( Work lo Be Done: <br />fJOTE WIRING IN NON-DWGLLINGS IS R[OUIRED TO <br />BE IN RACFWAVS, MC OR AC CABLE <br />Phone <br />( �/a�,J 35 � S9 r�c <br />Contracl Prico of Worl. <br />Conlacl Person (Plan Roviow) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />1 hereby ce•rldy fhuf I have �oed nnd rxnrnmrJ fhi� �ipph� td�on and knnw fhi� snrtie fo be frue and <br />��:ner.L All prowsions ol la�ts nnd ordinnnrc�s yova�nrng fhrs type ol worM wdl br cornplefed <br />�thether spec;hed harein or rrol. Thn �ren6nr� ol [� pennif dous not vesuni� fo gn�e a��fhon;y lo <br />•. n dafe or cflncel fhc novisions o/ eny ofhev Sfilfe OI IOC:J IflW IC(fl/IAIIncJ COlISf1(IC60I1 UI fhF <br />��„rionnance o! cons�rur.lion Thnl I am mrth��nred by (nr owner ol Ihis prnperty (o peAonn the <br />u�ork lo� wh��;h npplicntiun js mnde nnd 1 cernplp �rith tlie Sfafe Confrecfors Le�v 18.27 RCW end <br />:!+G 2�WAC <br />` �O� �_ l�l:��.r� <br />;. <br />�;;� ,��, : --=+r. , -- -- is;,�� — <br />FEE <br />� <br />