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t,�,�� I 2b�3 S 37A�� r!., 9ii3 P <br />_— —�— __`— � — <br />� ELECTRICAL PE�RMIT APPLICATION <br />CITY OF EVER�TT PERMIT SER:�ICES <br />3Z00 CC-DAR S7REET, EVER[TT, WA 98201 <br />425-257-8810 • FAX 425-257•8857 - vnvw evcr tt <br />e wa org g_ /`13 <br />APpUCATI0N5 ARr• ACCEPTED FROM e AM TO 4 PM �� �Q ��y'jj K <br />�ZO J VV �:�eGI�1 S"t' <br />PROJ[CT AUDRESS <br />i�NnOf <br />! �enart <br />Elec,ntai Contratlo� <br />Sta!e L�cen;e hwnOer vI <br />�roposed Use af Building <br />hlall Atldrec� <br />(dpll AddfC19 <br />141� � <br />�.!all Address <br />Clly <br />C�ly <br />Cdy <br />�25 3534�1 <br />Slatn/L�p Pnone <br />StaIC/Lp --�— Phone <br />Slate2ip <br />250 � <br />Cvr.lrad Pnce of Wo�k <br />Contnct Person (Plan Rev�ewl <br />Oescription of Work to Be Done. I Y� S � �Q,�� <br />� <br />Phone <br />NOTE: WIHING IN NON-DWELLINGS IS RLpUIRED TO FEE � <br />bE IN RACtWAYS, MC OR AC CABLE. <br />� l—( �0�-U0� <br />CI�Y OF 6VERETT LOCAL SAl.E3 TAX CODE IS 770, <br />� hn�ehy cePoly that I Aavo ruatl arrd ernmineU IhiS aUPl�cafion and knnw fhe same lo be huo en � <br />r.orrccl. All provisions of laws and o�U�nences uovemuig th�s lype olwork wi�rbo comp�etod �a <br />v,helher speciRed harem or np� 7ho gronbny o! a porrn�! dor.s not rusurqB (o prvo nulhonty (o — � <br />v�olafe or cancel (ho rprowsions ol any orhor sta�e or loca/ law reguPfuippconshuchon o� Ihe � <br />vo�k b avh ch nppl caf o/n rs adu anA 1 � mply w Ih �ho Sfate ConfracforsPLo v 18 77�C W�n,l <br />796. ZOJ WAC. <br />'ipnolure• � �� -.. "" na`q ��. <br />