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__, __....-'��1 ..:4�. .1�5J'?N977 BU'=r�H c�.Er:TFIIC II1�� F':;GE '��-;'ltl <br />0 <br />ELECTR�^AL PERMIT APPLICATICIN <br />CITY OF E'✓ERETT PERMIT SER.'� {CcS <br />3200 CEDAF STP,EET, EVERETT, W�+98201 ��_y3-o5 <br />425-257-8910 - FP.X 425-257-8857 - tiV,vw.everetb.va.org ���j i 2-� � 6 <br />APPLICATIONS ARE ACCE-PTED FROM 9 Atv1 TO d PM - DEQIT & CREDIT CARDS ARE NOT ACCEPTED <br />(�� ��� L..,1✓ldCVl <br />PROJECT ADDR[SS <br />- � i�1�/�� � �7 I S 1 �T" S1� �ve ve �� , ��-�- `'iSa-D I �{ t � 3v3 t 1 �-1 <br />OWner M2il qddress Cir� Slala2ip Phono <br />Tenant <br />Mall Address <br />City <br />State2ip <br />phono <br />�Su,. L�c�4,��.�w�. � E3�K lf�K3 �I�e ���c"ve�S, w�`�gt�g �( ��3�7871� <br />ElcdriC21 Con�ractnr Mail Aadress Glry State/Zip Phcn_ <br />�vscN Ez `�� 3 Qr <br />State Licenae NumUur <br />proposec7 Use ot �wlnlnp <br />Descrlpticn of Work to Be Dono: �'� e��C F� Y(' <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN R�C[WAYS, MC OR AC CA6L[. <br />�� <br />Contnct Price of Vdork <br />Contact Pr�r;cn (Plan Revlew) <br />CITY OF EVEFC-TT LOCAL SALES T!il( CO�E 13 3105 <br />! hrroby cer,ify that I hAva read and c�xaminea fhrs sp�+l�calen and rrncw !he some fo be trua and <br />�or�ect. All pmwsions of la�vs 7nd ordinancoS yovammg fh;s tyAe oI werk wrll be complefey <br />whelhC� spe„Ih2d hereln cr not. 7'ha p�antinp U� a pemvr dcas rof Fresume to give uutiler�ty 7u <br />ncrate er cancel rhe provisrrns of any other si.�(e cr l�cal law regu/afing censtructlon or;ne <br />,r,r�Aermence ot c�nsf�uction. That / am authuri�ed by ;be Cwr,Pr cflhi.^. prepsdy!o pe�ioini fhu <br />�vor;<!cr Hn�ch apFUcatlon is rriede and l camply wrtn a�e Stafe ccntractors La�v 78.2? RCV✓and <br />296.2G0 WAC. <br />I �"/ �- �- o q <br />F[E <br />� <br />��� -�il� <br />