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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SFRVIrFS `, <br />3200 CEI�AR STREET, EVERETT, WA 98201 ��7 - D h-�'�S <br />425-257-8810 - FAX 425-257-0857 — www.f;veretN-.�.org , <br />C— o�/c�-�� 3' <br />APFLICA710NS ARE ACCEPTED FROM 8 AM TO 4('M <br />::) �� '' : ✓t r �.i �%���GC <br />PROJECT ADDRESS <br />Owner <br />Tananl <br />_�.fcCf�cr <br />C-locl�icai Gontraqo� <br />SWte Liconso IVumber <br />Mall <br />Mail A�hliess <br />MDiI AdAress <br />� <br />r : .� �-5 <br />Gty <br />� Clry <br />rCY/`!'L y�; <br />City <br />Propused Use ol Bullding ' <br />Descnp�lon o1 tiyork to �o Ucine. <br />hlOTk_� 4VIRING IN NON-0W[LLINGS IS REQUIRFD TO <br />Bk IN RACE'_WAYS, MC OR AC Cl�BLE <br />s4,IdZ;p <br />StatefLp <br />State2ip <br />Ph�nn <br />Phone <br />Phono <br />Contract Prico o( Work <br />Conlact Percon (Plan Revicw) <br />�C � i r+7 �� / •- J -'Y J ��1 <br />CIiY OF EVL•RE1T LOCAL tiqLES 7AX COU[ IS 3105 <br />1 hervGy cr.niry (ha(1 ho v�� reaU nnrl examrnr.d fhls applL afinn end know (ho s�mv to b� inm e�nd <br />cerrect. llll proidsrens of Inivs and cuTlrnanc�is govenunQ tbis ryy�e ol work n�ll be eomplofod <br />n'hefhei spCpliBd hr.rein o� 7)OL ihn pnn�inp n( a pr�m�d does notp rusumc fo pi��o aufbority to <br />rio�efe a cance�! thc tuvvlsinns o! any nthe�r stofo a locn! Is�v ��ulepng con sfruetiun or tho <br />perferm�nce rl cnnshucGnq 7hpf I;im aufhonzod b�- )hn nNnvr vl fhls prvporty fu peAorm fh� <br />�serk lor �hicl� appli, a1i�;n Is m;�de �r�d 1 comply �rlfh tho Stafc CnnfracMrs l.aw 1 e.27 RCW pnd <br />'19(i?,00 th91t:. <br />Tl� 39rr j <br />1J3�3 1H9I1 N2f3Hl?JON <br />FEE � <br />�� <br />�� <br />� � �L �� <br />J / <br />8L586S9E79E EE�ST 800L/99/0i <br />