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� � <br /> ELECTRICAL PERMIT APPLIVATION <br /> CITY OF EVERETT PERMIT SERVICES I <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425•257-8610 - FAX 425•257-8857—www.everettwa.org I <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED I <br /> cj�J.J� FI�EQ(;,QcGrN L�A�/ <br /> PROJECT A�DRESS <br /> SO�VGRC"f'r (.aJL 7� <br /> c�nn!JToni./n.�✓�P 2GVe. Otp2A a�9a _ N�wst,erfjE�cH CA `31L�j0 <br /> OY1nef h1a11Mtlross Cfly SLita/Lp Phana <br /> A�.c.-o�vG ii�C 6c3ic �/7,r,Av� NL-" rLlo,eys✓«<t G.,.a 99�7d 4�o-cs;�-;�Jr: <br /> Tenant n�aunaaress Cny State2io Phonc <br /> ;�ducPc�r /✓!.� /�3oNFo��S'T Q�L4NGl�An} l�.0 9,9rJ.S 3i0-G�/- )/G5 <br /> Electrical Contractor M1faii ndaress C�ry Siata2ip Phonx <br /> S1CN.Cp I �J S''Y(-[..�• ��SG.00 <br /> SWte Lltense Number ConUact Pdce of tRork <br /> /PrSTpc�C,�NT PA�±:.. LQCUAPcLc� I <br /> Proposed Use ol8uilding Conlact Person (Plan Review) I <br /> I <br /> Descnpllon o(Work to Be Done� ,��fT•tI�L.4TJ_Q�F__f?�2LGSN AY .41a(iN:aro CN,O.v�c.__ i <br /> � �rr/z S'imN i <br /> I <br /> NOTE: WIRING IN NON•DWELLINGS IS RE�UIRED TO FEE <br /> I <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> J�S.GG <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> 1 hmoby r.crtily thnt 1 havn m.ad and oraminr.d fhis npplicafion and Ano�v fho s�mo to bo fruo and <br /> cu�recl. All prov�sions o7/aivs 3nd ordinancas govemmg fhis fype o/�sorY,u�ill Go complafad <br /> �rd�cfhw spual ed he�em or not. Tho granfing ol a pe doos notPresi�me to giva aufhonty fo � <br /> :�o!afo or c�ncN fho provrsions o!o fher sfato cal aw mgu a6ny constructi�n or fhe � <br /> pr.rfonnanco of consfn�cfron. T am aufho otl Ay t o�rner o/tms property to peAorm fho <br /> ^�ork lor which applicafion is ado an I c ply urfh o Stafc Contractors Law tU.2i kCW and <br /> 29G.200 WAC. <br /> ` - � '' °s �.S <br /> Slpnaturn Uate -/ <br /> �/�� <br /> I � <br />