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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET"f, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org � ` a 6–r�� <br /> APPLICATIONS ARE ACCEPI ED FROM 8 AM TO 4 PM (-d 6O l—� y � <br /> �.,� l.,( , ( . � � � � 11� � �� � � lii '� ` / ! `� � �) � '-1 i� iO <br /> PROJECT ADDRESS , � <br /> � � <br /> � 1 � � '� �1_��.� � ' � i � , <br /> Ownm ����—? Mail Address City Slale�Zip Phone <br /> � C", c� l ! (f (? <br /> l� ,�-�.�, , ,, t, < �� , �� � ( I'�.� k��u, , a „1 , >>�,�«,,.�,�— <br /> feqap� � ail Addrnss � Cily StatelZip , Phone <br /> � 1��;_, I i , � � � �{_,�,����,� 3 G=�l l_�-,�,� h' �c.•� '�:5'�r - :1 i � � <br /> EleddcAl Conlraclor Mail Address Ci(y Slale/Zip Phone <br /> C`� <br /> l� �� �,,;� ,— �Y <br /> ��-�/l_iI 1�i �� � /y ��_ /_ (� J �(12�`0 <br /> Slate License Number Contract Prico o(Work <br /> Proposed Usc ol E3uildin� Contact Pcrson (Plan Review) <br /> Description of Work lo�c Donc: I��.�� l,{ 1� cf.i -f ��r-1 G. i � h �� ��16 i � ..- . <br /> 1 7� {� <br /> ✓ � <br /> �-Z: f,l �� � �� � � � 1"�[_� ilr �'{rriC ! IJq ,Y� � c� l� l ����iclkr - <br /> � .i � <br /> NOT[: WIRING IN tJON-pWELLINGS IS REQUIR[D TO FEE <br /> E3F IN RAC[WAYS, MC OR AC CAE3LE. �� �•rt'1 <br /> � �7`j --J <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I <br /> I horrb��avbl}�fhnf I havr rend and exarnined flus oppucntion und know the same fo be In�e and <br /> r.��noct All prr��fsians o!laws and orAmanres r.ove�nmg fhis type c!work �rill be complefed <br /> �rhethcr spec�hed hcrem or nof Thcr granfing cl e permR Aocs not presume(o give aufhonty to <br /> v���lafr oi cancel lhe`novisions ol any ofher stofe er li�oal law�egulafmg construc6on or Ihe <br /> pe�lormance o!consfrucfion Thal I eun authori:ed by fhe ownrr ol this property to peiforrrr fhe <br /> �rorp (oi which epplicnGon is rnnde anA I comply�srth fhe Stafe Contraclors Law 18.27 RCW anA <br /> ?JG.200 WAC. <br /> i <br /> �J , �' � <br /> �•t c , ! ( . ' , a . � ��., 7 ,, , '� 1 ! ' � - <br /> � tiignatur� D�tc �/ <br /> � <br /> "�/ /y� <br /> �� <br />