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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -vn�nv.everethva.org 3 - a-1/ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM L �,U �(D 3 -�Z. <br /> � ��� �� � a�, �,t � c�- <br /> PROJECT ADDRESS <br /> rl I <br /> _3 7 �J I �v. 71 fJrJ(' f ` IY `� ��� i1t�lY 1U�3rt5� li t� ✓ s c�Af4454 vas S�y1,q5A <br /> Oxncr f.�J hddress City StalerZip Phonr_ <br /> 3 ��`C� V � � 1 ].1�1�1 .LJr��fSr S � �5 �y�t 'sr$�Su Y�$ SU.4-2�SL <br /> Tenanl fdail Addre:s C�ty Stal?!Zip Phone <br /> j�,., -,�w� I�r� ��� H naC.,��r�u.( 7� f3v�. i3zGd �r�..l�r.u(� 5�1v� ��G �i.b-�alj <br /> [In.,�.r.cal Ccnirador M�J Aadress C�Iy State/Zip Phone <br /> L��n 5 r � 1 9 �/<<lU <br /> Statn License tJum'uer CoNracl Pnce of VJork <br /> J�:mY���.�,—Frl: Y�SS ,°�;Z�SZ <br /> Proposed Use ol8uilding Contacl Person (Plan Review) <br /> Oescriptron ot Work �o Be Done: _.���t,�1 L (1��1N 7/�f�� � b v� <br /> ��. <br /> NOTL WIRING M IJOIJ-DWELLINGS IS REQUIRLD TO FEE <br /> H[ ItJ RACGVJAYS, h1C OR AC CA[iL[. <br /> CITY OF EVERETT LOCAI SALES TAX CODE IS 3705 <br /> 1 hcreby ceriity thaf I havc read and examined fh�s applicatiun am,hn�w fhe same to be lrue anJ � <br /> correcf. A/l provisions ollaws and ortJinances goveming tf�is fype ol work �rill be complefed I 2 ` UO <br /> whelher specdied herein or noL The granfing ol a permd Joes nef resume fo grve aufhority to �� I Q 7 <br /> viola!e or cancel the provisions ol any olher atafe or local law reyuPtmg consWcfion or tho j, <br /> peAnmiance o/cons�ruction. Thaf 1 am aulhonred by the onner el fhis prepeAy ro perfonn tlie G <br /> �vnrk for which applicafion is made and 1 comply wilh fhe Slate Corlraclors Law 18.27 RCW and <br /> 296 200 WAC. <br /> - - 3 -z -�ol� <br /> S� haWre Dale <br /> ���...� . II <br />