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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 J a --I?-��7 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org [ n7 � a• t9(o� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> \ � <br /> . ,') � i.� i;�l � �_�� � � l l (� �� � <br /> PROJECT ADDRESS <br /> �;���� � , � �,., L"� C?-'C'1 � C(� . C c; r� ����1 S <br /> Owner ��il Address Cily Slale/Zip �'���n�• <br /> � <br /> �`=� �)'� I � iC <br /> Tenant - Maii Address City State;Zip ���<>��� <br /> �,��11�11C�11'r�'(� l:(i�JL(� ��]7 �7 (����� C�'� �1V�, �'�Z�i /���� (' �-2d.�- W�'-- <br /> f-lecirical C n�rador hlail Atldress City SlateiZip ��,iG ����(�y��/� , <br /> � L. <br /> L-D»C� ��n 1 C �1 � �� Z `� I � U (''� r� <br /> St�te Licensr, Number Coniracl rice of Work <br /> r������������1) j-�� <br /> --7 <br /> Proposud Use of L�uddin9 Conlact Person (Plan Revimv) <br /> / ,� <br /> Urscription of Work to Be Done: �� � �/ (,il � �� �� �1 ��� -{� � <br />' NOTG WIRING IN NON-DW[LLINGS IS REQUIRED TO FEE <br />, BE IN RACE\NAYS, te1C OR AC CA6LE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � I hui��bc cr6/y INad I h�i��r rr.�d,�n�r einminrd(his applicafi,>n and Anou�fho snrnp fo be Uue nnd �- � � <br /> �,wr� 1 All pro�isians nl Id�vs��nd ordmraric��s go�'�'�nu�a fhis f}p��u(�rork �sdl br cornplefed L� � � � U��� <br /> n�hothcr specdied herrin or nof The yianGnr7 0l a pernirt docs nof nesunic fo give aufhcnfy lo <br /> i iolate o�cnnrel the Ivnvisrons o!nny olhr.r slafe o� local law�epu�itin9 r,onshuchon nr Ihe <br /> prrtonnanw o/consfiur,lion That I nrn aulhonzed by fhe owner ol fhis p�ope�ty lo perlorni th�� <br /> wnrk lor wbiclr applieafion is ntnde nnd i complyjvifh fhe Sfete Con6aclo�s Low 1(3 27 RCW end <br /> ;9ti 200 WAC. , , �� f . <br /> �� "` � - � / '" / � / r�' `/�-- <br /> il �--� �/��` . `l� � � � / � <br /> 1 <br /> I -� Signalure Uale <br /> � __ <br /> i <br />