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ELECTRICAL PERMIT APPLIrATION <br />CITY OF EVERETT PERMIT SERVICES _.�, � <br />3200 CEDAR STREET, EVERETT, WA 98201 — <br />425-257-8810 - FAX 425-257-8857 — www.everetlwa.org L_^��'� (� _� �� ��J <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />'7�/7 7S� S7`� 5 E <br />PROJECT ADDRESS <br />� i � _%,.v � J 5 .3 /Ol �% �i¢vL A.2 cI/ / AF,,-••, .4- C� �' ��/U-6 <br />Owncr Mail Address Ctly State2lp Phone <br />Tenanl <br />j <br />/ � <br />-i f-r 1i , 1!' <br />__—_.__—.___�_ <br />M11ad Addross <br />Q <br />[ledrical Contr�clur M1tuil AJdicss <br />SL'C �_ %FL` L �G� 3C�/ <br />Sla�o Licensc Nwnbrr <br />Propos�rd Usc ol l3iuldin�� <br />c�ty <br />Siale/Zlp I'hone <br />Clly / Slate�Zlp Phone <br />�� <br />_L � �' �� _ <br />Contract Prir,o of Work <br />Conlar.t Porson �Plan Revir,w) <br />[1es��.ripiion ol Wurt �o [3c! Done�. P44i %t /l- m.�.-(� �[� j}/�- �_�/��.-- <br />NOT[: WIRING IN NON�DWELLINGS IS RE�UIRED TO <br />BE IN R',.;FWAYS, MC OR AC CADLE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I lu�ii�b� rertilp Orrt 1 ha� r re�id unA ca�nntuiod fhis npplica6on and kno�v fho sarno lo bc fruo i�nd <br />i:one�Y� All pio��isrons ullmss and �vdmmices qorcrning fhis fypo olwork will bo complrfed <br />��h�rfhi�� s�rerdird hoirin o� nof Tl:e gr,�nfin,4 ci! n perrnR Jo�rs nof uosumo fo gi��o aufhordy I�� <br />woluto �v cnncc!!he /nnrisians cl any nfhcr sfnfo o� locnl Inw myulafing construcfion or thc <br />pertornranei� ol cnnsf�v�r6on That 1 t�m nuthamed G}� fh�a o��nor of Ihis proporty to por�crm (he <br />w-ork l,n nluch �ippGr;rtion is maJo and 1 cornply nrth fhe Sfale Cenh�+ctors Lnw IA77 RCIV end <br />79f : i�ir N'AC. <br />--��, �i � <br />�-� � � �=� ---- . <br />�,��n�,�i,��,� - <br />-� �� - <br />1 a�c <br />FEE <br />� <br />� _ / �� <br />� �`� <br />