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Ed_ECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3?00 C[DAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www everetlwa.org <br /> APPLICATION� ARE ACCEPTED FROM B AM TO 4 PM <br /> � � ' C> <br /> , � ',�� <br /> PROJECT ADDRESS <br /> l'1 4 - � 'ti <br /> . � � <br /> _�., �i ,� , � �(� �v�� ��� i�� �e� �(, �) t��• ��, ) ' � �(� � V1 � �� �� `[ <br /> 7 <br /> Owner hlailAddrass City Slale�Zip P�one <br /> �/��� �� � <br /> / � — - <br /> � � ��� ' r �' �{��� �� //-� � �"'i ,��� �� L �i� i , „� I'� "zrN I��� `' J � c ' � � � ` <br /> Tenant ' Meil Address Cily $late/Zip Phone <br /> ji , 1� / �( ' i. , V,'f y� ' �) • <br /> � � � il ' I�,�� ' '/L:- �Iv� �C� l'It �. �� lL1N / � c � ) � <br /> Electrical C trecto� Mall Address Ctly SlalelZip PGoua <br /> L � �c i' ( !N l /� r' —��Ll' ` � <br /> Slate Lir.ense Number CoNracl Price of Worl< <br /> ; / c' <br /> � � � l'� .� � / � � /i�� f���� I.� r > 111 .'�ic — <br /> Proposed Use of Ouilding � � Contact Persun (Plan Review) <br /> Oescription o1 Work lo Be Done. ���. . ��!� �.;� ,�S�<� � � ��I 1�'`'��'L . � �� �, 'i�_� : , �l i,. % <br /> � <br /> � � � I C , � A: � }� <br /> NOTE-: WIHING IN NON DWELLINGS IS REOUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> i hereby certJy thaf 1 have read and examined fhrs appGcation and knrw fhe san:�fo be frue and <br /> rr,rrecf. A9 provrs�ons ol/aws nnd ord�nances govemmg fhrs type ol work wrll be completed <br /> irohefher spec�6ed he�ein or not The c�ranfmg o/a permd does nof presume fo grve euthonty fo � <br /> wolafe or cancel the provisions ol any ofher state or local law regu/atmg construchon or the <br /> peAormancr, ol construct�on 7hat I em eufhonietl by fhe owner o/this property to peAorm(he i <br /> woM/or wduch epplication is maAe end 1 comply wifh fhe Sfate Cor,fracfors Lew 78 27 RCW ond <br /> 29G200 WAC. l <br /> i I <br /> � / <br /> i <br /> i� -' /�' - � ���� ,� �'� - <br /> - ignaWrc � DAte i <br /> � <br />