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ELECTRICAL PERMIT APPLIG:ATION <br />cITY OF EVERETT PERMIT SERVICES ,ab_�Z <br />3200 CEDAR STREET, EVERETT, WA 98201 6- <br />a25-257-8810 - FAX 425-257-8857 - www.everettwa.org C!�.O �-1 u d <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />1y2��,� Muwltco ��� <br />PROJECT ADDRESS <br />�, l 1'��'S VV�'1`^"�� <br />[l er MailAadicss ��N <br />7a�0�� Mail AfJdfC99 <br />Squnre Footage (If �eaidential new conslruction, remoda� or eddition) <br />�N��I�n p <br />Oescriplion of Work to Oe Donc: <br />'C1n �S (S � S��+Lt a� <br />NOTE: BERN R�P!CEWAYS MC OR AC CAB EUIRED TO <br />CITY OF EVERETT LOCAI SALES TAX CODE IS 3705 <br />1 hnve rcad and exomined this <br />nrsa nrnrnoa�7ha qnnt/n9 ora <br />and <br />.ic'd L59�LScSZbL�01 <br />City <br />Slatamp <br />Slalc/Zip <br />W k �1X'1,� 4 � <br />StolC2ip <br />Contract Pnce oi Work <br />Contacl Person (Plan Review) <br />r�'1 •v �'C,�� <br />iow fhe samv to 6e truc and <br />wnik wilf bo canpletod <br />esuma ro grve euthonry ro <br />ing can51/uCfrOn or fho <br />�is propeRy to perform fhB <br />octors La�� 1 ti.27 RGW and <br />FEE � <br />� � <br />Phono <br />Phonc <br />Phone <br />E(Z0� - (►�� <br />�NOiJd 20�oT 2T0z-t-T-83� <br />