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ELECTRIGAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 rJ-I�o-�O <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org G'����D� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �b�� �-(�ctiL 'hJE � �1 rv�tfr, wA 9� � <br /> PROJECT ADDRESS �2s <br /> Z57r �i(-'ZC� <br /> zwnl w-Rl�nn� cti�v_u+ q-4g4- A�4ea. rtv� �vti,a.r� w�A 9�-'z�� <br /> 01mef Mall Addreas City State/7Jp Phone <br /> L}bl� R L 6tYL /r Uc <br /> �LN1ftL $'�Y�c'11�1._ � 1'�'�eST� WIA `� �V3 <br /> TBnenl Mail Addreeo C�ty SlelelZip Phone <br /> �A�E��C-t"S5' <br /> �"►-F '�� w�CR. �b21 S'W Llc jZpES�hc`t R-� gN�How��9N, WA �25- �j30-"764�' <br /> ElecMcal onUactor Mall Addreoa Ity SlaleZp Phone <br /> Stete Ucense Number Contract Pdce ot Work <br /> `�hr�4uNt.�,� <br /> Proposod Uso of Building Conlact Pereon (Plan Revlew) <br /> Descriptlon o(Work lo Be Done: �V���5 (�� 1��+�h� 1 N�i'�`rt'ii v� J �f�1 <br /> '��_9ur+q4C,1 <br /> NOTE: WIRINO IN NON-DWELLINGS IS REDUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL 9ALE9 TAX CODE IS 3105 <br /> 1 heiaby certf/y fhaf 1 have read end exominod Ihfs applicaUon end know fhe same fo be fruo end ��Uo��—(�Ql� <br /> cortncf. All proNslons o(/ews end ordlnances govemfng fhls rype ol work wlll bo completed <br /> whefherspeclfled horeln or nof. The grenfing ol a permit does nofP resume fo give aulhonty to <br /> vlo/efeorcancelfhe rovlslonso/anyoffiersteloorlocallawreguletingconshucNonorfhe <br /> perlormance o(consPructlon. That I em aufhorized 6y Ihe owno�oI Uils property to perlorm fhe <br /> wo�ic/or whlch eppllcaflon Is made ond I comply wifh fhe Sfefe Con(mc(ors Lew 18.27 RC W end <br /> 286.200 WAC. <br /> ~ pr Ntnr�hE tt � �i U <br /> ture Date <br />