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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �a _ ac7-Or'J <br /> 425-257-8810 - FAX 425-257-8857 - www.everPltwa.org E o�,a��56 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� � � <br /> l�— C./9�5��,� C�`" . �� /.��[' <br /> PROJECT ADDRESS .:��5 '���/ <br /> C/f l / `"�✓/ i0 J �/�/rY7T (� � � ��/�7.� <br /> i <br /> Ownof � Aiail Add�ess City Slate2ip Phonc <br /> Te�� � Mail Address � � 7-N GlY- SIa�NZip Phcne <br /> /�i'��. �' � � 't'� �/,.15 iZ�F <br /> �ct. 7 T N �l�� T c L>>,�� 5T =�,� � �r 1� 9��5�� 3 `I9 3 <br /> � ° <br /> Eleclrical Coniractor Atail Address C�ly Slate2ip Phone <br /> �'�,�T� % :� � T //////��^��,. , Fin,�/�c (• •� <br /> Stale Liccnse Numher �oniract Price ol Wor6. <br /> ��' <br /> �� �v' � �� , — <br /> ProposeA Use ol f3uilAin�7 Conlac� Person (Plan Review) <br /> Description ol Work lo�c Donc: ���G( � pi��� / � ��� <br /> NOTE: WIRING IN NON-DWELLINGS IS REOUIR[D TO FEE <br /> BE IN R�CEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT I.00AL SALES TA%CODE IS 3105 <br /> I hrrrby certily fhut 1 have r�ad and exnrnineA fhfs npplicNion and kno�r fhe same fo be frue nnd <br /> convcl. All provisions ol la�vs and ordm�ncns c�overnui�fhis type o!worA wtll be contplefed <br /> �rhefhm specd�cAhercin or nul. The c�rnntin�o!2 pennR Aocs nof/ucsumc fo grve aufhority fo <br /> violatr or cancel ttm I�rovisiuns o/any ofher sfale or local law rec�u afinc�cons6ucfion or fhe <br /> perlormance u/consfrucfion. Thaf!am authorized by Ihe owner ol fhis property lo perlorm fhe <br /> work lor wluch npplicafion�s nroAe anA 1 cornply wifh fhe Slnfc Conf�adois Lnw iB.27 RCLY and <br /> zsc zoo wac. 1 <br /> �- ,) � 1 ` ) ,ft�, � . n <br /> � � <br /> ,�,-, t..�.,. <br /> ��---� o � <br /> s�pnn�u�o <br /> ��� �� <br />