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ELECTRICAL PERMIT ARPLICATION <br /> CITY OF EVERE'�7 PERMIT SERVICES �r _� �—ib <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � � _C�� <br /> 42.5-257-8810 - FAX 425-257-8857 - www.everetlwa.org C rG' <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> , <br /> —1�1�— � r.. <br /> PROJECT ADDRESS <br /> .�, 2 li� � �`7 /C'' c' 4�Si ��c� � �" j % LC-�e' �„ � / i '; � �� •�, <br /> Owner hlailAddmss Cuy Stale2lp Phonc ��b- ��� , <br /> � , _� �' ' �� i(� ; �,��;;�iir.� .-r !"� r'�' �' w/1 l/� 5« `I,Ci_ '/ <br /> 1- - <br /> Tononl n1a�i Addiess Gity Stalo/Zip Phone <br /> Eleclricnl CoNror.lor ldad AUdicss City StatelZip Phono <br /> i <br /> '�ti <br /> Stalo Licc�nso Number ConUact Pric�of Work <br /> Proposed Use o(Building Contact Person (Plan Revicw) <br /> � . i <br /> Description o�Wurh to I�rr U��n�r. --_-_----��--�--------- <br /> NOIE WIRRJG IN NON-0WR_LINGS IS RE�UIRFD TO FEE <br /> E3L IN RACEWAYS, ��1C OR AC CAOLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 heraby coitily tl�at I ha��e read nnd exavrrineA Ihis npplir,nlion nnd kno�v fho sante fo bo fnie end r_- - <br /> canacL All provisions o(la�vs and orAinnnces�ovoming fh`s typa ol n�ork will6o complofed ( ( �'� Lj '( ` 7( �- <br /> u�hefher spnci6ed heiein or noL The g�anlinp o/n pernirt dces nof/iresume to c�ive n�rthority to <br /> ���olafe or cancel tho`�rovisions ol any ofher sfafo or local l;�v��qu nting consfruchorr or fhr, <br /> pe�/onnance o/constiucfion. That I am t�uthorized by fho on�n..�o/fhis p�operty fo pe�lornt fho <br /> u�ork!or wbich applir.�fion is made and 1 comply a�ith the Stafe Conhnctors Lew f0.27 RCW and <br /> 296.200 WAC. <br /> , ' � .,��� " ' .. �,-� _ �j. <br /> C <br /> . � � � __.. ----- <br /> __'—__' Signa�urt�' . .__ ' '___'—_'__—_' Ua��� <br />