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------- <br /> _--- <br /> ------- <br /> ECTRICAL PERMIT APPLICATION <br /> E'—�ITY �F �V�R�TT PCRMIT ��RVICES G� _� 3—� 2� <br /> 3200 CEDAR STREET, EVERETT, WA 98Z�1 <br /> 425-257-8810 - FAX 425-257-8657 —www.evereltwa.org <br /> qpPLICATiONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � I <br /> ,^ ` ,�v ����^�— C-- �J� f'��or <br /> I I S �� e�" � . I `' 2��f � <br /> PROJECT ADGRESS � �o �Qj �` J1z r <br /> ✓ e �,�� c- L c 5���''L-- � � <br /> ____�-�-�Ph��e <br /> �C� . 7��\�_ � � CiIY- Sta�Zip A (.IL/,n,yC-� <br /> ` � r� <br /> v- tnad Addiess I I I C � �VRe,�. �ry I� G(. � -- <br /> Owner l <br /> i /.. • _ f.�...... � 5-e�✓E�� Statei2ip Phonc <br /> ��f'� MailAddress ���Y <br /> Tenant �t�l�S L'w~���c� Aw,�/'N• �:vQ f� �3 �6��Y"L`�/ <br /> ��""� �___C�— >ea f�"_ - Phone <br /> ,��� SlatelZip <br /> Cdy <br /> Electrical Conlractor ,,,}}}��� ��/��' <br /> Mail Addies, <br /> I � / � \ � \ � 4O ' ' `� <br /> cx�= / ontract Price ot Work <br /> L �— <br /> Slate t icense Number <br /> Gn(� ��� Contact Person (Plan Review) <br /> h-h <br /> Proposed Use a(Building <br /> �-�--- <br /> Squaie Foo��9e (If residenlial nev�conslwclion, remodei or addilion) OV� '� � <br /> _—__---5 r�-�J�D��----- — <br /> Oesc�iplian of Work lo(3e Done: �� � 1-- �„MS '�Q��_.r_-- . <br /> � � � Q��— �i�e�� ,�,w �, r J � - <br /> '�r _____-- - -- <br /> _,-- <br /> ---- r�F � <br /> NOTE: BE'IN RACEWAYS MC OR F�CI CApqUIRLD TO � �/, � - _ <br /> l/ <br /> CITY Of EV[RETT LOCAL SALES TAX CODE IS ?105 (� !�, <br /> inanaes novr.rning Ih�s fype o(w��me�b'yive+wfleonfy lo <br /> 1 hem,b cc�idy Iliat I have read and e�xammed Ihis ap�iicafion and knPs✓O�e same fo be frue and �i I ZO-l ~D�/� <br /> canect Y AU proms i n n s o/l a w s a n d o <br /> wlrefher sper.dir.d he�cin ontof. Ihe granhn�o(a p e m u t d o e s n o t r, <br /> violafe or cancel(he provisions o(any ollier sfale or local law reyu PhnJpconsfiur,fwn o r f h e <br /> P orrk lor vih chrc pPl cation is madc anJ Pcomply�w�fh fl c Slale Gon(rac(or�l�.�w 1��2�7 PC�V'ind <br /> 296,200 WAC. � <br /> . - ���_r� �----- <br /> ------- ��,�� <br /> � --- --- <br /> - --Sgnaluic - --�'----- <br />