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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES a �o�i� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �� <br /> 425-257-881C - FAX425-257-8857 —www.everettwa.org C, IID Z'"� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �c% �C,� %UL�I L-/�' �1/r <br /> PROJECT ADDRESS / <br /> U Zy <br /> _� 33�— <br /> f'ir.�� ,�'C�;� �:r�; � ��c;� -��;c �c�f' �'1v� �v�..,{ .�.�— ,vA �9R Zo / y� r <br /> O�Vnef Idall Addres=_ Ci�� Slaie/ � Phone <br /> Tenanl L1dil Nddicss Cit�, State/Zip Plionc <br /> �1 J IU2l� i <br /> Elec�riC31 CONf3Clof A1�il Address Ciiy Sta�e/Zip �'����'" <br /> Slate License Nuinber Contract Frice ef WorY. <br /> Proposed Use of�uild�ng Contact Person �Plan Review) <br /> Oescription of Work to Dc Uunc�. ��F UA/��!'–/.�c�+i'-� �D�L�U/T � ��/' [�/�d <br /> _1"'� ,•1 � 'v/c";: �/fit/� /�//1I/� /'�n�✓l �I–�/OE 7� — <br /> %�/- 5/��' _— —� <br /> NOTE: W IRING IN NON-DW[LLINGS IS RGQUIRED TO FEE <br /> BE IN RACFWAYS, h4C OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CUDE IS 3105 <br /> !he�oby ccrti/}�fhat I have read and exarnined fhis applicafion and know Ih,�sarne(o bc truo anA <br /> cormct All provisions o/laws and oreiinances govem�nq fhis f�7�e of�sork �sill be cempleted <br /> whefher specdied herein or noL The c�r.�nfing o(a pennrt does nof��resimie to give authority fo <br /> violafe or cancel the provisiens ol any other stafe or lecal leir regu ating consfruchon or fhe � <br /> performance o!consirucfion. ThaY 1 am authorized b}�Uie oirner o/this preperty Io perfomi Ihe <br /> work!cr which application is made and 1 comply wifh Oie Stafe Cenfmctors La�v 1817 RC4V and \ _ �1 � � <br /> 29G.200 N�ACi, ; � ��%C1 <br /> � ;- / �'� � /� � <br /> " / i ii..�; � /� <br /> .��';!"j �'>..;�;.:: �/D <br /> ' ` Si natute � � ° <br />