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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 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 2�l �e C� II�� 57 , C �c RE i l v✓A `1`tzJ � <br /> PROJECT ADDRESS <br /> AAN M (/RP�� �I 2irG �_ c'r�� �.� si t v��zcTi wia 9hzv i <br /> Owncr Afail Address Cny SlaleiZip Phone <br /> Tenant Mail Addross Cily Slale2ln i hone <br /> 9gow <br /> i S(e �Ircfi�,c Irc ��G/a ��i�a��� W. ��MD�I�l � �{ ylS-7��'�3�0� <br /> —f------- <br /> f_loClfiCal Con�laClOf M1tail P ldiess City 5(ate2ip Plwne <br /> Czsc�FzG��'1 oN __ �,?3yD "° _ <br /> �talo LicAnse Numb�r Conlract Price o1 Work <br /> S,'�+dr �iln,�/� <br /> Pro�>�d Use o(Bui dinc7 Conlact Porson (Plan Review) <br /> De�criptionolWorktol3eDono: /�l U Qlt UD � �r�[ �i�Cu� �U�C/ A��hC / . - <br /> NOI�t= WIRING IN IJON-DW ELLWGS IS RE�.]UIRf_D TO f[E <br /> E3[ ItJ RACEWAVS, MC OR AC CABLE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 horeby ceriily Ihat I hnve reaAend ext�mined this epphcr�fian nnd know fhe�nme to be f�ue enA <br /> correcf. All provisions ollaws and orAinenr.es c�cvernin�fhis lype o'work will be completed - �� �c` <br /> whefher spr.cilieAhornin or nol The�rnirtmg ol n p�nmt dnes nof ��esume to give aufhority fo [ (A, l �. <br /> violafe or cancel lhe pn>visruns ol any other sf�ila a� iocn!la« regulnGng consfn�ction or fha <br /> peAormnnce o(const�uch��n llraf I am nirthonnd b} fh��o�tirier oRhis p�operty to prriorrn IhP <br /> woik!or wh�ch t�pplicafi���i �s m���lo anJ I rornpl� «rth fhi� Sfafr ConGacfois La��� iB 27 RCIM1'and <br /> 29G200 WAC. <br /> � ' � ._. ,< .- !Z" l1 l�' <br /> _ ���� � .:. y _. . . . _ __.___ _ . ...._. <br /> $IgnR�UIP. � I)3�P <br />