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r <br /> , - <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 6 - �7-05 <br /> 425-257-6810 - FAX425-257-8857—www.everettwa.org �y��qb_�p� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> �hP � hE��;('.�1'1(U� �iY��:�ilti���'�r� <br /> PROJECTADDRESS � <br /> �'1{V�`�-�l'iY\�PV\ ��1�o`L'°�i`mPrd'i �LC. �ti:. �iG Wr�il„�v.IIP- l?.•.In��n�� �� � N� r (�t-cicV �� `�ci� k �ti.0 <br /> OWne� MailAddress Cdy Stato2ip " Phone <br /> 1,..i�t1Mu�IIQ Wf� `7'S�: 1� <br /> � <br /> �Che jl�4i'��.��n� ��ti��� 10��� _1-r�Glu41�r�1 1'�v,�_ (:vP'cPt-t ��/} �f`i�,ci <br /> Tenant MailAddrnss � Cit� SWto2ip Pnono <br /> �stluNt �_lPt�v�t.�����1 . li;l�l� l� `i�i `if�= Hv,l��-i�� u�r�1 `('���i ��- �15��5)'s�3��t� <br /> ElecViplConN�ctor MailAddress Ciry SWtetip Phone <br /> C - � O C' �� � ��j• `- <br /> C% i 1�—I.LC���71 il> > <br /> State License Number Contrad Price of Work <br /> C�-l��( f'�;.:/vri' 1'1a1�`,(' Q.DI���-4 ( ,�-��1a11�_ <br /> Proposed Usa of Buiiding Conhact Person (Plan Review) <br /> Doscnption of Work to Be Dane: I;U1�lc��' �-�i'�:�.'..1�:{ `�i' Y��C-('� �.�-�1'� L?-����l r'� � - <br /> 'v.,;t\1����_.�,�'�t-� C4,1'V� ��n�`.i�. � f<jl,l i �>�'1{�_\"��'. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO F[E <br /> eE IN kACEWAYS, MC OR AC CABLE. �_;� <br /> I � I ,��- : <br /> CITY OF EVERETT LOCAL SALE3 TAX CODE IS 3705 <br /> i horeby corti/y fhef I have reed end exemined this epplicafion and Imow the seme to Ge frue end <br /> conect. All provisions ollews ond orrlinencas govemmg this fype o/vrark wil!be comple!ed <br /> whethar speci(ed herein ornoL 7he grenting o/e permR dnes not prosume to give eufhonty fo <br /> violefo or cencel fhe piovisions of eny otherstete or bcel few 2guleting construdion or fhe <br /> perlonnence o/cronstruction. Thet 1 em euthorized by the o�vner ol this property to peAorm the <br /> :rork/or which applicefion is mede end 1 comply with fhe Stefo Contrectors Cew 1B.27 RCW end <br /> 296.200 WAC. <br /> ,; , ;' .����-�;.;:� � -� y- �,,� - <br /> <. <br /> - �/ Signaturo , Date <br /> �tfiS�C� -l�l <br />