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[t2iq1/:i�ll El?:�1.`� 2536392027 REMI_D FAGE 03/03 <br /> �_'_, <br /> I <br /> ' ELECTRICAL PERMIT APPLICATION <br /> i CITY OF EVERETT PERMIT SERVICES <br /> I 3200 CEDAR STREEf, EVERETT, WA 98201 <br /> 425-257-8�10 - FAX425-257•8857—www.everettwa.org <br /> ' AppLICATION3 ARE ACCEATGD FROM B AM TO 4 PM <br /> I <br /> i <br /> I _�15 E �US��nO �c� <br /> i VROJECTADDRESS <br /> ! �-- t � ��� 5 ,� ca �i4�o R� =�� ere�k � �r� qszo� <br /> i CMTOt MadAdA2ts Gry State/Dp Phone <br /> ; �1-li 35 ► � cc�si �� c Rd C- �rer��t� wA �� 82� <br /> � Tenant MaU Addres9 Gry 31a1.✓2ip Phone <br /> I ^�i��l�� `J��. ,�1.,���� � 1 ��)L� � �� 51� .���i���l ��' 1'���1� LiJ'�l � 1K�1"7� ��J'Zl ''�4 - �:_y- /i <br /> � Eieclrlc�IConlredor ManAddress Cry Stsle2ip t�hone <br /> � � <br /> � �,r1l,,del`� � Y � I W t�L/ -�' <br /> Slatr. Lirr.nse Numbef Conlroet Prioe ot Wmk I <br /> � f'rODOSCtl Urr, of t�uildin �1� •``�`��t1 � , <br /> 8 Contnd Person (Plan Rehew) <br /> � Descnption of Wo�k fo[3C OOne. LC, (C(.'11 i' (�11U1(� 1 � �U �„L � <br /> I <br /> I _, <br /> ! NOTE WIRINOINNON•DWELLINGSISREQUIR[OTO �E � I <br /> l3E IN RACE-WAYS. MC OR AC CApLE. <br /> i <br /> i CITY OF EVERCTT LpCqL SALES TAX CODE 13 J106 <br /> !hO�CbJ CBrtily lh�f I haYC lBed a0d 6xBlliined fNiS BnpliCBfiOtl 6nd Aflow fhe 53RI9 fo b!fNP.end <br /> � c��rr.d A�l�'owyrons o!le�ss end unimencos yovernirrq t�ls typc ol�vork N•ill bo cvnrpleted <br /> n��'ethJ�SpOGfrEd he�Crn 0�nOL The gMOtiny ole pCRitK dop5 nOt presume ro givo au(ha�ry fo <br /> �,o'a!o o, ca�ce/fhe pro�a�ons o{any olhvr stete vr Ixal lew rnpulating consL uc6on or fhe <br /> � f�:�onuam^e ol c:ons�n�ct�on. 7Tat�anr aufnanrud by fne o�tir�er o/fhisPmperty ro pedom�tbe <br /> . pork fo�wh,;h aUp�rcabon Is matle nnd�romply wit/r fhC Sfete Confrtic uro Lpw f0 27 Ri,W any ��/ j <br /> ; :96�011'AL'. <br /> , _ U <br /> ,' ,, i, <br /> � ;Y� i `'`� I <br /> , <br /> ; ,�:(� � •�- I.•�f <br /> � S�gnature Date <br /> I <br />