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��c. . . .:�I. ���' j'.^��i� <br />� . '�lli '� . <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEUAR STREET, EVERETT, WA 94201 <br />425-257•8�10 • FN( 425-257-8657 - ��nvw everethva.org � <br />f 2-�O /3 <br />APPLICATIONS ARE ACCEP7E� FROM 9 AM TO 4 PM � �� � 7�� �` <br />�/ <br />_��v��� -�t_,I;�st1 �,� �1�C?�' I <br />PROJ[CTaDD ESS <br />Tenant <br />[lectrical Conliaclor <br />t,a�� naa�� <br />R1aA ntldress <br />b+a il naarosa <br />j ��iC� M H �101 C��i <br />i Statc L�cense NumL•er — <br />oiy <br />Clty <br />� Z5y 7��13' <br />$:BfCq�P PnOr,c I <br />� <br />Stato4�p Pho^e � <br />Cily SlnlelZ��p <br />�V / <br />Conlr�q p; �cv o! Wenc <br />Preposud Use o! Owltllnp Cvnlact Person (plan Rov'uw) <br />Oescription ot VJork l0 6e Dono: �� r� ��`� <br />°hone <br />NOTE. WIftIIdG IN NON•DWELLINGS IS R[QUIR[D TO FEE i <br />C�E IN Rl�CEWAYS, NC OR AC CABLE. <br />CITY OF EVERGTT LOCA� SALES TAX CODt IS �105 <br />-� S�U �� � <br />1 hereby cert�ty tha( 1 hnvo raaU ond oreminoJlhis npplrcal/cr� anU knOw fhe samo to ho (ruo antl <br />conocl AH prowswns ollsn�s and ord+nances guvom�ng (his typo of trork i��rll be comnle(ed <br />who(hor ipecdfod horem or nol. Tha Brenbna ol a parmrt doos nof res�rr�d fo pron aufhonfy (p �I 21 �— I�%� <br />vrolote or can��a! (he prov�sinns of any other sfaro o� locai lew re6oPolrng consliucuon orlho ��� ` `� � <br />peAormanco Of conStruCLon. 7hot I am euN�wrred by Ihe o�.ti�7or oRhrs prope�f�� fo FeAwm tho <br />t�iork /Or uhich applrcaG'on is medd and I tcmpfy wiDt (ho Slnlo Cr.n7rQ�/ors Lo�•� 18.27 ACW and <br />Z96 700 WAC <br />