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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES 5-16 -o� <br />3200 CEDAR STREET, EVERETT, WA 98�.01 <br />d25-257-b810 - FAX 4?5-257-A857 - www.everedwa.org � Q g0 S-(�� 3 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />, , ,- <br />, �'I/v'�� --�n��'� ---`=��= <br />OWn(Jf �d�ul Address <br />Icnanl <br />Coniraclor <br />Slale 1 icense Ntunbor <br />Proposed Ur,o ul Nudd��n� ' <br />I.fad Address <br />Mail Addicss <br />��'1 �uo 1 ��, <br />Cily <br />City <br />cny <br />L/ _ . <br />S�/' j O�. :, �/ �i _ <br />SIaINLp Phone <br />SlalelZip Phonr <br />Sla�e�Z�p <br />Conlracl Price o( Work <br />Conla!:� Pcrson (Plan H�•vir�c) <br />I�none <br />Descriptiun of Work lu t3c f��.�n�� —1-,'_ '� Ci, /yr� % �� I L-----.-- ----_--- <br />NOT[ WIRING IN NON-DWELLINGS IS R[OUIR[D TO FEE <br />fiE IN RAC[WAYS. MC ORAC CAE3L[ <br />CITY OF EV[RETT LOCAL SALES TAX CODE IS 7105 <br />I herehy rertrl� fh��t I li+i� r�orul anA rxamuioJ fhis npp6�:uhon nnd kno�r fhe sanm fo Ge frue anA <br />� nnect All prnv�si�dis �,l L��vs and o�Amnnc��ti ga� enuny fhis tppe o/ �tnrk �rdl be rornplcfod <br />n�h��(hcr sp��cil�rd hcrc�n or nut. The g�n��hnp ot tt pennrt Jor.s nof rrosiunm to pire aidhonf}� fo <br />ri�:d�3tr or cancel fhv vovisions ��l em� nfhrr e�Grt� or locnl In�v rogu��f�ny construcf�un or U�o <br />p<vinnnance� of r.ons�ruc6on 7hnf 1 iun r+�dhori:od b} fhe rnvnei of this proporty fo per�o�rn UiN <br />noik (o� n�hirh anp�ic.ibpp es n�ade and I compl} �vrth fhe Slete ConVncfors Lc�w iH 21 R_ ✓V and <br />; ���i 70U N�AQ---' <br />� ��� <br />. �� _ � <br />.. . -- �� ��� <br />�, �.i ��--�f'. � . _... .. Da(t� ----- <br />'�•:i�.71�uo ' —��----.. <br />�%i <br />!� <br />� 0� �,� - (ic � "'� <br />