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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES g � a7`p-� <br /> 3200 CEDAR STREET, EVERETT, WA 982C1 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org � Q I���/�,v <br /> APPLICATIONS ARE ACCEPTED fROM 8 AM TO 4 PM <br /> - � � �� <br /> , . � <br /> PROJECT ADDRESS <br /> � ���1 <br /> =-=-=-� ' 4 -._' '_�_�__�� -=-- -- <br /> OWner h1ail�dAross City Slale;Zip Phone <br /> __. _. __ ._ ..___—. _ .__-. _ __ . ..__ _ _. _ __....___ ._____ - <br /> TAnf1n� . . . .�� f�1a'�1 Lon. �;i��, ::lale Lp Phune <br /> \ -t � l <br /> . � ��, �� . � , ���1��� �;�.� {��_ A1� �' �._ '.� ���_. . �� �• � : � � � ���� �� <br /> �-_ <br /> [leclric�l COnlrector � Moll AAdress Gty Slale/Zlp Phone <br /> � � ` '�: �_� /,.� . , �'—� — <br /> L <br /> State Llcemse Number CunUact Prir,e ol WorY <br /> Propo,ed Use ol f�iuilJinil Conlac� Person (Pian Rrtviaw) <br /> Desc;iplion of Work In P�, ��un�� - -� � �l'h'�l l �.Y U � ��--- — � <br /> µ, __i�--�-�- ���`��' �`Us..) `)l �� �- t_ ��� l�� <br /> _�_ <br /> NOTE: W IRING IN NON-DW f-.LLINGS IS REOUIRED TO FEF <br /> BF IN RACEWAYS. MC OR AC CABLf <br /> CiTY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> 1 her�r.� certily thaf I haeo rnvd end exe�minod fhis epplicnHon nnd hno�v fhe senie fo be frue and . <br /> cormc( NI provisions ollaws end ordinnnces yoveming fhis fype o!wori� will be complefed <br /> Nfiethe; >peciGed herein or not Tbe g�entiny o(e pernuf does nof vesurne fo gire aufhonfy Ic <br /> violate oi cencol fhe provisiuns o!eny ofher stnle or loc�d lew regulfl�lll(J COliS(NCIIOII 01 fhP <br /> peAonnnn�.e ol contt�uction. Thet 1 em authunzed by fhe ownP���fhis property to partorm fhe <br /> worh !or H-hich epplir.nfion is rnnAe anA 1 compty wrth fhe Stofe `ecfors Lew 1H 2� FCl4'end <br /> 290 200 WAC. <br /> � / j � . <br /> �.".___._ _-- ____- - —� —_ - <br /> --�� -�Lunulure - Ilate <br /> L dr�L�Q l�l:" <br /> -- ------- � <br />