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{ <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT, �'JA 9R201 <br /> 425-1.57-8810 - FAX 425-257-8857-H�ww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 1 ^ <br /> _�� I U ��J� `� c'3�.�� c, 17 ���� <br /> PROJECT ADDRESS <br /> i '�A �r��l-�i 1��in�l�l1 I��iC�V�:�� f��� :��r�, i'���, .l�v�l� � � ',� �lk� `'�`�% �IxI; <br /> OWner Mall Addre��s Clly Slala/Zlp Phone <br /> �v ��,�� ��IU l,'��' �� (��5��, � �'���, wlr� r�, ��1�'. _ <br /> Tenanl Mall Address Clly State2ip pho�c <br /> �h�t�i_cL' ��_1�>�4�,�� �11�%c �, �y�� A��v���r�l�l,{ �, �+��h �;>,}{(u Ul� `I�',I.Sy '1� ��?,'� l,x�C� <br /> Eloclrir.al Conlr �or Mall Address Clly Slale2ip Phono <br /> C/ ��ti� C�4' � �!�, � � c�; <br /> ��f�1 r T - �� lk LY' � <br /> Slale Uconse Numbcr Con�racl Prico of WorY <br /> PropnsrJ Usc ol F3uildinq Contac�Person (Plan Reviow� <br /> Doscription al Work in�o Duno: _h_�.� �i �_L' �Y ' � .: � � �'�(�Jt...S ��1 1�~ ���L�� _ <br /> NOTE W IRING IN NON-DW ELLINGS IS REOUIRED TO FEE <br /> [�E M RAC[W�YS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SAIES TAX CODF IS J105 <br /> I hemhy�ceriily fhaf I hare maA nnAeAeminoAfhis app6cnfion end Fno�v Ihe seine fo bo f�ue and <br /> corrrcf tlll pro��isions ollaws end ordinances govorning this t��pe ol���ork will be complofed <br /> �rherfhrr specified horein or nof. Thc prnnfinp ol�pnrrnif doas nol nosumo to give euthonty fu <br /> ��iol��fr ur cnncM fhe Ivovisiuns olmry ofhor sL�fe or locnl lnw re�ulafing consfnicfion or the <br /> perlonnanc�e!constiuction. Thnt 1 nrn outhorizcd bp(hc owner o!fhis p�oporty fo pedom�fho <br /> �voi6 lor which app6cnfion is mndo nnd I complp wifh fhe Sfate Conhm:lors l.ew 18.27 RCW and <br /> 296.Z00 lM1'AC. <br /> i <br /> ' I�'� . �I� C�(� <br /> i.� �l � r-, ( � �� <br /> � <br /> �. � �_ rl�_t' �:r � ti� U ' `� � I`�� <br /> Si�nrdwo � -__— —Dale � `t1/ <br /> �V� <br />