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753-981-999fi LIne1 07�.56:05 09-76-7017 5/6 <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org �_"a 6—)7 <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM C I}O��'��F3 <br /> (�-� E�� �-� 1.�..� . C'�-na tz.al <br /> PROJECT ADDRESS <br /> a� <br /> ��.�� �t o �� 3�10� S�en�e v.��'�)�� (���o <br /> Owne� fAail Address Ciry SlatelZlp Phone <br /> __��K�4 <br /> neN �ilA��S �� Clly SletelZip Phone <br /> as3qat <br /> Cerv�mun► ra�,cv�g /e Pc�c. 5 � f=rrn� l�� 1��- ��03a-- U11Oo <br /> EIBCIdcF11 Contrector Mall Address Clly Slele2lp Phona <br /> ��CC� S�-��C� �h`.+ � ✓'� 7� "_ <br /> Slale License Number Coniruct Pdco of Work <br /> �O�In�c�ra-M �- <br /> Proposed Use ol Building Conlact Per.� �lan Revlew) <br /> Doscdplion ol W ork ro Be Done: �� O-T�'�-�� �-'�`"� ' `-'� �✓�-=' �"���D_ J <br /> � � �2�'�y .- 0O2�('>U <br /> NOTE: W IRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �O <br /> �� <br /> CITY OF EVERETT LOCAL SALES TAX COOE 13 3105 <br /> I here6y cortily fhat I hova rr,ad and examined thls epplicetion and know the same fo be true nnd `I�!` <br /> corrocf. All p�ovisions ollaws nnd ordinances govem/nq fhfs type o!work will be complefed L VG� — I' f � <br /> whefhor specdied horeln or not The granfing ol a pormR does nof preswne to give authority fo V• � 7 <br /> violato o�cancol the provlsions olony ofher sfafe or lor.al law regulafing constniction or fho <br /> perlormance o!consfiuctlun. That I om aufhonzed Dy fhe owner ol Ihis property lo perlorm fhe <br /> � wurk lor whic6 applicafion is made nnd 1 comply with the Stafe Conhacfors Lew 18.77 RCW and <br /> 29G.200 Wl1C. . <br /> =���'``�n�-1��'��� �� � � ( Z - <br /> �ynoWre nte <br /> ._____—_'_----__._ ._— — ' <br />