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/ <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 6_ I 8—D� <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �'� D�06��� <br /> � � <br /> �' �� ��v1li�� �:-�� <br /> � <br /> PROJECT ADDRESS <br /> G����/UL'�lCti� <br /> Owner Mall Address Clly Sta�e/Zlp Phono <br /> Tenan� M:MI Address Clly StaleiZlp Phone <br /> L�2l.� <br /> �,1Latit'/7l _L:��:� �C� /,t�X �9� E'ilT ti�f^a `�'2/3 ZSi�3� <br /> Elec�rical Contrac�or Mall AAdress City SlatelZip t`hone <br /> % _J��� <br /> L�1%� fILLr';���CC --_ <br /> Slate Licenso Numbcr Conlract Pnce ol WorY. <br /> lIIC'TSILC ��12� <br /> Proposed Us�of�uildinc� Conlacl Porson (Plan Rovi�w� <br /> D�scri��lion o1 WorF Io 0e Dono: �Z[�^�/GC 17�G�TE— J�J'v/��-C- � ��2 <br /> NOT[ WII�ING IN NON-DWELLINGS IS RE�UIRED TO FEE �� ` r <br /> [3E IN RAC[WAYS, MC OR A� CABLE ' <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> 1 hemby corfily fhal 1 have rr.ad and exnminnd fhis npplicidion end know fho samo fo be frue and <br /> r,oirecL All pro��isians o!l�ws end orAvinncos yo��ermng fhis fype o!work wil/be complefed <br /> whefher speciGed heroin or not Tho granfing o!n ponrirt Aoes nof prusume fo giao ou(honty fo <br /> violafa or crmcel fhe �rovisions o!nny ofher stnfe or loct+l lew regulefing consfrucficn or fhe <br /> pe�fornwnco ol cons�rucfion. Thnf 1 mn euthoiizeAby fhe o�sner ol fhis property fo peilunn Ihe <br /> worti /u��t4tich npplicofion is madA and I contply with(he Sfnte ConUActors Lt+w 1B 27 RCW and <br /> J9G.200 WAC. /� �� � <br /> _. , � b� , <br /> 1 ^ <br /> ---- ��,r����- C.�-- (�y� /��-- <br /> � <br /> sin�citur« -- — U� e <br />