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� 1�! <br /> � �. <br /> _ _—_' ._."'_'—__"'. ____. . _ — � <br /> I <br /> li <br /> ELtCTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEftETT, VVA 98201 <br /> 425-257-8810 - FAX 425-257-8857—v�nnnv.everettwa.org <br /> AP�LICATIONS ARE ACCEPTED I�ROM 8 AM TO 4 PM <br /> �I�2,7 Cvcsr,�Ce�'ti �-'ay <br /> �— <br /> PROJECT ADDRESS <br /> ��, ���.��cc �3� R�k��;���. G���#-- �A- ��� <br /> � <br /> Owner MallAdtlress City StalelZip Phone <br /> '�,t j-'���c�� �I�2� Cu�;�f��,,� �v�� �✓� <br /> Tnnanl MailAtltlress Ciry Stalc/7.ip Phone <br /> 1,11ey�s�- ��'�� ��� �f�i�ls. M�,��l�k�� � l�- q9�.�3 3Go- y�y_«2,� <br /> Eleelrir.alConlractor tdai�Atltlress Clty Smte2�p Pnone <br /> �11e��SG�i2��( lW� <br /> Slate Licens Number Conlmcl 'rice of Work <br /> `�e�u�� �3�l� L. y�,ch' , I <br /> � <br /> Proposed Use o/Eiuilding Contacl Person (Plan Review) �. <br /> I <br /> �1�`�"` o�, (.Jc.V.�V� ����5 <br /> Description af Work lo C3o Done: 1 _ <br /> NOTE: WIRING IN tSON-DW[LLINGS IS REQUIRED TO FEE <br /> B[ IPl RACFWAYS, MC OR AC CAE3LE. <br /> CITY OF-EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereLy ceifily fhpt I h�ve read and examrned fhis applicafia�and know fhe same lo bo frue and <br /> conecL AI!provisions olla�vs and ordinances poverninr�tlns type ol work will Ue completed <br /> wlretlrerspec��ed lierein ornoL The 9mnling oI a pe�mrt does no!p�esurne(o give aulhanty(o <br /> viola(aorcancellhe provisionsolanyatl�erslnfoorlocnllmvmgula(ingconstmctionorlhe <br /> perlonnance o!caislniclion. Thaf 1 am aufhonzed by Ihe owner oRhis properfy ro pedonn Ihe <br /> wodr/or which aeplicatrort is rrtado artd 1 compty tt�ilh!he Slafe Confrac(ors Lnw 18.2i RC W and <br /> 29G.200 lh��C. <br /> � � �/'� 2,- l9- lo <br /> SignaWre �' �alc � <br /> 02�6 <br />