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I; t' i`''�G . , , '�� -� �`, . ' � �'. i <br />� "- , -- � <br />. � <br />; ELEC.TRIGAL PERMIT APPLICATION � <br />. CITY"OF EVERETT PERMIT SERVICES <br />3200 CGDAR STREET, EVERE"f T, WA 98701 <br />429-257-8810 - FAX 425-257-8857 - v�n'nv.everottwa.org <br />APPUCATIONS ARE ACCEPfED FROM E AM TO 4 PM <br />PR�� %IC� I� �lc�r�� `' _ �°�L'�- <br />JLCT ADDRESS <br />i [� � e�' C�� <br />enant I <br />Eleclrlcal Convactor <br />A1a�l AdCr>ss <br />�vt`I � _ <br />M1ied ACtlfB55 <br />���� <br />h7ad A�dres� <br />�So�z�rP ��'����y� <br />Stzte Ucense N�rnber <br />—��`�4;���` � -- <br />P•o{, sed se ot BwlCinp <br />U�scriptlon of �Yotk to Be Done: � �� � <br />Cn v1.�"6 / <br />hOTE: WIRING IN NON-DWGLLINGS IS FiL=QUIRED TO <br />B6 IN R/�CEWAYS, 61C OR AC CA�I F. <br />� <br />CITY UF tVER[1T LOCAL SnLES TAX CODG IS 9109 <br />Ciy <br />C�y <br />c�p <br />S <br />SL�'rJZi�. <br />Statc2o <br />��7�� �C <br />StatclZio <br />rnoro <br />Hnanx <br />Pncnn <br />�� 3�.��;�,o � <br />�en SYvz � ' -- <br />Contact PersOn (Plan Revie�•+) <br />1 hereAy coRi`y fn�t 1 have reod and exam�nt�d fhis oppGcalwn dnd knOw fhe same to Ce true and <br />ccrrecf. Ail pn�vis�ons c11aa-s ard ordmances 9cvemmp lhis type n/ wortc w�p be cemplr.foQ <br />whether sAewfied herern or ncL The pmntmg ol a pemi7t does nof prosumo fo aivc aufhanty to <br />violate or cance/ the provisions o/ any ouier statu or loco� �aw rugulo}%oq consGucDon cr the <br />p3rfonr,nnce cf cunsiructlon. That f am auif�enzed by Ihe owner o! this property (o per�orm fhe <br />�vork lOr �v/uch appliCalion i5 maCc ond 1 comply wilh the S�(�te ConGac(ors Lmv 08.27 RCbY and <br />29ti.z! LVAC. <br />. �1'�'.���I �_ � G�Z'�/ � <br />,_ V`"$�9�ature � u��w <br />����E �� �� �� � -a y.� <br />� � {�,.� � �n,��� GUi�wu� � <br />�_..� -.___._----.-------� <br />FEE � I <br />��� ; <br />�I�'OI IOW" <br />