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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �_ S�� Z <br /> 3200 CEDAR STREET, EVERETT, WA 98^<01 ��za�{-oa5 <br /> 425-257-8810 - FAX 425-257-Bb57 —www.everettwa.org <br /> APPLICATIONS ARE A(:CEPTED FROM 8 AM TO 4 PM <br /> �7,�� .� ' . ����)�L�� ( �` � �L <br /> ��� �' `� �'�� � CC�S(iVC� �(Yl�['� � <br /> PROJECT ADDRESS ' � � � • {� ''`'1 <br /> ;-� ,, ... �j,�c� � '� �ti'. ( �. ;,� ,� �1 �� f_�� � � ti � , �, <br /> Owner• � Mail Addmss Gly SlalelZlp Phona <br /> �.1�� �ti�(–, — <br /> Tonant Mail Address City SlalalZip Phono <br /> ��zS"141•S 2nc, <br /> � " , ��� E =1F��'���'« � `��x� < <�i� tx 11�'��_ < < �=� i���� �_ <br /> Elec�rical Conlfaclor Mail Address Clty State2lp Phone <br /> -, t� ���, c,2 <br /> �� � ,<. ��._��_� 1 �',`� V � <br /> Slale License Numbr.r Contract Price ot Work <br /> 7 <br /> (s,� Y �I ���1 �G .� 1 � 1�t'yl,� <br /> Proposr,d Us of�vilding Co tact Person (Plan Roview) <br /> 1 � <br /> � 1 ( � � .. l �,�,�: �_ ,z 1�� S �� ,�F•�,<< � <br /> Descriptinn o�Work to Do Dono: -1 � -'1Cti�•1\� -` I \\\ ��� <br /> � /, — � I i L. �,�,� �.. <br /> � c . , p. 1 �.. . � �- -t�. / Pli �2�� �:� r 5 <br /> NOTE: WIRING IN NON-0WELLINGS IS REQUIRED TO F[E <br /> BE IIJ RACEV�'AYS, MC OR AC CABLE. � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 / , L� <br /> I <br />�� 1 heroby�-ort-!v Iliat I lrare read end exmiiined this npoliinlion nnJ know fhe snme fo bo tnio nnd ���� - V <br /> corral. All pro�islons ollaws ond ordinences govoniing fhis typo al work �sill be complefed <br /> �vhcelhe�s��ecilied hereln or noL The pranting ul a parnut does nof nosurnQ fo�ive aufhority fo <br /> ��iclulo o� cancel fho trrovisions ol t��ry otlrer state or locnl Inw re�ulnting consfrucfion or the <br /> perlonn�nce of construction. Thaf I om aufhorized by fhn o�anor ol fhis`�roporly to pedonn fhc <br /> 1YUlA IO/N'FIICII A/)�lIIG71I10l1IS /77i1fI0 a!1(II COOI�II}'wifh fhe Sfnte Contrncfors Lew 18.27 RCW and <br /> 99G 2001M1AC. ... � <br /> �� ��� � �� � � � L� � z <br /> , _ <br /> ; -- <br /> .._— S��neture �-'- ------ --Ume — <br /> �----- -------- <br />