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O4; 112C�13 1J:43 253-63i-7754 PEOVIP�NT cLECTF'-IC �'�"= �=��= <br /> I <br /> ELECTRICAL PERMIT APPLI�ATION I <br /> � <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 C[DAR STREET, EVERETT,WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-�+nvw.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I <br /> � -- -- — ---� <br /> �lq� l�i� W L c3I- ��- � <br /> PROJECT ADDRESS "t`-Y I j I <br /> c.u��• I <br /> ��1��(��-�IUQ� �D V�DfC 1442+-� �IIU. L��EE'-- .4G <br /> OvmCt Mail Address Cdy S1ateJZip Phone ( <br /> � <br /> Tenant M1lailACaress City StateJZ�p P�'�'�e <br /> V�L�D�1� Ft�'�L iNL 1-'b_�D������N�Nt.:s��a�x�2���.?sc <br /> IilectriWlConiractor MailAddress Ctty State2ip Phone <br /> � <br /> }"�,�1TCr I D�LZ <br /> State License Number ConUact Pnce of Wodc <br /> Praposea Use ol Building Co ct Persan (PI o'Revre� <br /> Oesaip�on of Work to Be Oone: � �� C v���="-'-�—�`-_ � <br /> I <br /> NOTE: WIRING IN NON-DWELLINGS lu^REQUIRED TO �E � <br /> BE IN RAC[WAYS, MC OR f�C CABLE. <br /> �p .�,i <br /> CITY OF EVERETT LOCAL SAlLS TAX GOOE IS 3105 .- I 7 /,�I _ (�} � <br /> 1 hereby cerfrfy tAat f have read and examir,ed this apolicafron and kno�v Ne same fo be hve antl �� � l - � <br /> covec! A!I provisions of la�vs and ordinances go�emmg this fypo o/work wdl bo complefetl <br /> �}�he(her speafeC herein or noL Tho grsnGng o�a permrt does notp rosume to give authortty to <br /> v'olateorcancelthe provision5ofanyolhersfatcorlocallawre,qulaGr,gconsfn�cGcnorthe <br /> p¢rtonnance ofconsLucfion. fiaf f am authnnzod.by the ownnrolfhis prapeM to podorm Ne <br /> work torwhich applicaffon is mado and I comply wrth the Siafe CorVad�rs La�v 1827 RClNend <br /> 29G.200 WAC. i <br /> �/Y������ � <br /> SlgnaMc ��10 � I� <br /> _—_I <br />