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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 /> APPL ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �Lo( 7 LEpA�� S7REET <br /> PROJECT ADDRESS <br /> �l-f N GN�IRG(1 ?�cl � GFp¢R S_T E,i ,tErT' 1/�1/��4BLo � �Y2S�2S4- 2?35 <br /> Owner Mail Atl�ress City SlateiZip Phone <br /> Tenant Mail AAdress Cily Slate2ip Phune <br /> ��l��i� 3�iti 5l��i Si E�F�2Et� Vuh�g02oi C��, Zs2-4a4r <br /> Electrical Ci tr�c�or Mail Address Ciry StateZip Phone <br /> �v� c4 [j.11� Goa3i.< < <br /> Slalc Liconso Numbar Conlrac�Prico of Work <br /> PmposeA Use ol C�uilding Contact Person (PI2n Review) <br /> DescriptionolN'orkloBeDnn��. TE��POLti�i2u SET_RVLLE� flu Pi4��/_Il.l LJT EASZ� DF SLNODL <br />, R�Il_�)tl�1L:,-'-__-----_-- <br /> NOTE. W IRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> [3F IN RACFW�VS. A1C OR AC CAE3LE <br /> � SD. Co <br /> I <br /> CITY OF EVERETT LOCAL SALES TAX CODE I� J105 <br /> I h�vrb�r��rtdy fhat I hnvr,oviJ nnd erdrrnrd fh�s appl�;n6on anA knun fhe sanie fo be frue and <br /> cana�rf All provisions c,l lanti r�nJ ani�nan����s n����rrnmy (his fpPc ol wurh wJl he cornplefed <br /> w6i�thnr speci6rd herein or not Tlte g�enf�ny 5!n pernuf does nof vesunie to aron eufbonty fo <br /> violate or cancel fhe Inovisions o!en}-ofher sL3fo or local lew rec�uliUng consfroilion oi fhe <br />� pednnnnnce of conslruafiun Tlrnl I arn eulhonred by fhe owner u!tirls Property lo perform the <br /> worN lur which npplicalion is maAe and I r.omply with Ihe Sfale Cuntrectors Ln�v 78 27 RCW anA <br /> 29G200 WAf. <br /> � / <br /> - ���� - 1s <br /> _�-��-�u"�'_=�-�'�--- ����o�a � <br /> s���,,�i����, <br /> _ --- ---� <br />