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ELECTRICAL PERMIT APPLICATION � <br /> i CITY OF EV�RETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � � j_r 7 <br /> 425-257-�810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS qRE ACCEPTED FROM B AM TO 4 PM � � zv�� "' <br /> i7a�� - and �v�e �sE <br /> I PROJ[CT ADDRESS <br /> �yabil h�t"a�� 1 Taha�1-�I�-e��cl ��I�)�il� �Y���� <br /> O�n�ner Me�l Address Ciry StalefZip Phone <br /> i <br /> Tenonl M11a�i ntltlress � Ciry SWte¢�p phone <br /> �jy' . `-C_N�V,�y1.LC !�10?� � ��1 �T �G�V.��? � W(�- °�SOo 1 (aC(o�7'� ��' <br /> E�edrical Conlreclor Mail:.daresa Gry S;atelZip ahene � <br /> 1 <br /> Sk�te License Number GonVact Price oi Wortc <br /> Pmposed Use ol Building COnlac�PersoO (Plan Review) <br /> � Square Footaga pl re5iden6al new ronsWcUon,remodel or atldilion) <br /> IDescnp�ion o(Woik�o Be Done: ��DY�I.YV A6�h1{� � d�� ��'lt� <br /> �_I--' <br /> NOTE: �VIRING IN NON-DWELLINGS IS REQUIRED TO fEE <br /> �E IN RACEWAYS, MC OR AC CADLE_ <br /> � CITY OF EVERETT LOCAL SnLES TAX Co�E IS 9105 <br /> II heraby certily thst 1 have read and examined tnis ap�licafion and know fhe sanre to be frue and � /, / 17 Q <br /> correcL All proviSlons ol laws and ordinances govermng this t}pe o!work���II ba complefed I Z(J`� V > (� <br /> � w•hefher spocified herein or not. ilie granting o/a permit dnes nof pmSURIe to�ive aufhodty to <br /> � violato or cancel the ploVisions ol any ofher state or local luw rngulabng construction o�the <br /> peAormence ol constntction. 7hat I em authonzed by the ownsr of fhis property t0 pedorm tho <br /> Iw'ork fir which applrcation is mado and/comply witN Ihe Sfato COrtfrecfors Law 1 B2%RCV✓and <br /> 2sa.zog�v,�� . <br /> i C <br /> l�.�?�QA� �(o��l �o( <br /> �tGre � ❑ e <br /> l_ <br />