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I <br /> _ _ -- - <br /> --- __ <br /> --- -- ----- <br /> ELECTRICA.L PERMIT APPLICATION <br /> CiTY OF E1,'ERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �/G(/�hr � <br /> ����-- � �����U� RA. d6i�ri� i•y' 9o,�d <br /> PROJECT ADDRESS I <br /> l' <br /> 1/� , �a '�2N ' !S � f'i/`l <br /> Owner Mail Address City SlatelZip Pnone <br /> I iiyi��F I�'(iG.vi l�b:v�zr.�t C6 �P,c - 3n f �n���,., � tv..-�rJ}i. .J. �L'S 7�S'�l- �7� <br /> Tenant MadAddress C�ty YState2�p Phone I <br /> �� <br /> �t c n� � ['%�s 7'f T^ � %:�E�/ �j� l� j,iL S6� AC'dv.-i/Y, C['°q-. [�''?�+'d'' <br /> a �� <br /> [lecirical Cunlractor Mail Address C�ty Slate2ip Phone <br /> �f��� `ii7LY � s�� � <br /> Slate License Number Conlract Price of Work i <br /> Proposed Use o(�uilding Contact Person (Plan Review) <br /> /�U^'' � <br /> ---•_ <br /> , Square Foo�ag (I(residenlial new cons�ruc�ion, del or additioni <br /> I �f �1 /�� �,� �/ <br /> � Descriplion o(Work to Be Done�. T.S��'rt9S kL P�T_�'r1� /E't'B�L�=i.-i"'-�-�=�-' "'7 <br /> I � <br /> I <br /> � NOT_ WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> DL= IN RAC[WAYS, MC OR AC CADLE. �(� �U I <br /> _� <br /> ' CITY OF EVEHETT LOCAL SALES TAX CODE Ifi 3105 <br /> ' 1 hcreb}�ccrtdy fhnf I hnve mnd and e�nrnined this��pp6cafion and know fhe samo fo bc 6ue and �1 � <br /> conect All provi,ions o//mvs and or�lnwncas yovernmg fhis type ol�vorA wdl be coniplefed C I c�-I Ll- I `. <br /> �� �vhe(her speci6ed hercin or nof. lhn g�d�nto�g ol a pennd does nof p/ESII/710�O(JIVO aulhonty to <br /> 'i violate o� cancel pre -�ovisions ol nny ofh�r stnto or locnl low r�yidn6ng consfn�cfion nr fho <br /> pc�lnnnance ol cans�nichon. Thaf I nm authorized by flre o�rner o!fh�s properiy fa pe�fonn the <br /> n-ork lur �:fiir.h applicalion is mnde and I comply�vifh fhc Sln(c Conliaclo�s Laiw 18.27 RCW nnd <br /> 296 200 WAC. <br /> ��",,�[,6��_���1� h . /!��/3"'/Z�i2 i <br /> � � , �� � r r I <br /> iSig eWre ale <br />