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ELECTRICAL PERMIT APPLICATlON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —���ti�✓�v.everett�•�a.org <br /> APPUCATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> y �v � Col,� �i ��t� <br /> PROJECT ADDRESS <br /> i� f / I <br /> �J 7 UI U�ti �� �J /� ( I`G5 h�� I1(�lY 10�`Sa�s�� �..�. 5����.s c� Ay'g�53 v1S5u�3195� <br /> Owner f II Addmsa City State/Zip Phone <br /> 3 �� �u� l�� �rr�r� �.1�� 12,Urv �Or"stS —��.� SIu1�,-5 i��1 Y�$25� `f155tJ.4-1,�.�z <br /> Tenanl - Mail Address Cily State2ip Phone <br /> ���i+� ��t1Y� �iI'i: �� �� I r��'�t�L..� l� 13J� 131�6 �r�l� Lt/lr�- 9.�J-U� tvG )i.�-f:°�� <br /> [IeclricalConiractor dAddress City StalelZip Pnone <br /> I��n � r R 1 9 9��IO <br /> Slale License Number Conlracl Prico of Work <br /> � �/,�SS�i�- z�s.� <br /> Proposed Use of 8uilding Conlacl erson (Plan Review) <br /> De,criplion oi Work to Oa Done: ��f c��r^ �L�.I �K�nLL� � D �'� <br /> Y <br /> NOTE: WIRING IN IJOtd-DWELLINGS IS REQUIRED TO FEE <br /> aE IIJ RP.CEWAYS, tdC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE�S 3105 <br /> 1 hereby ceAily fhaf 1 have read and exarnined fhis application anJY,now fhe same(o be true and <br /> correcL All provisions ollaws and ordinances guvemrng fhis fype o/�ti•ork�rill be completed �� �C�� <br /> n�hefher specilied herein or noL rhe gr�nbng o(a perrmt does no! resame to gi��o author�ty to /� L <br /> violafeorcancelthe provisionsolanyefhersla(eer/ocallawreguPfingcensfruc6onorthe �� ��L� <br /> pedom�ance olconstruc(ion. Iliaf 1 am aufhwized by fh�:on�ner c/Ihis p!cnerty fo pedom�fhe /� <br /> work/or which applir,ation is mado and 1 cornply ni(h(he Sfat� CenOacfors Laiv 18 27 RCW and /i <br /> 296.ZQQ WAC. <br /> /J <br /> / --- � <br /> _ Z , U <br /> alure Ualc <br /> \ <br />