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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES o . <br /> 3200 CEDAR STREET, EVERETT, VVA 98201 (f - �� - a <br /> 425-257-8810 - FA� 425-257-8857 -��n^���r.everettw�a.org C'� 9 ���1�7 <br /> APPLICATIONS ARE ACCEPTED FROA1 8 A�1 TO 4 PM <br /> , <br /> � �' L� 1a ` '�rc �<I <br /> PROJECT DDR SS <br /> Ku��1]!. 1 �1`�-<"�'�"L�—_ ���/� --�t'�'-- ----� �/�lf-�fiO-7i�ti <br /> �: '1,,'I ___—.�i: i � i <br /> O»'nor � Idail�ddress Cits <br /> titaL�:���,� Phonc <br /> Tenan� A1ail�ddress Cily SlaleR�p Phonc <br /> Q� Fl �Ir� �7�1� ISFr" � Nc __J�rJ.i o•-� �.r• 4F«a3 y.�� z3/-dL^3 <br /> [leclrical Canlraclor Atail Address it� SIat�2�p Phcne <br /> RiSr�r ���/�lA `�''��� Y o00 oc ___ <br /> Slate License um6er Coniracl Price of\M1brF: <br /> �� c �<� �'�I i / ' t /� c y�li�J�-.� ��1-- <br /> Prop'6sed Use o� 3wldinu Conlacl Pason �Plan Revier:� <br /> l ./ <br /> Doscription o�Work ln 30 l�onc�. �11',�iy.:_ __11.1ih�- 1IJ C�_t-�`_�iS�.��''—:>!�i'-- ' s i•r,�• -- <br /> ,l � r � dr.i: � � l dC� -r._� s(� <br /> }�,•_L1�/'[ L..'4J'�h��S��t 1 i.ulfc �]t�rl�y�:-'2+'-�t�l �N+-�—+t_'� <br /> NOT[: W IRING IN tJON-DW ELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAI'S, MC OR AC CABL[. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 -7. <br /> I hereby certily fhaf I hare road anA examireA fhis ap��lir,alien and knoir the snme to be frue and ���1 � � - � � -i <br /> conect All prowslons o(la�vs and ordinances qoeenunc!fhis fype of work rrill bo completed <br /> �ihciher specified hercin er nof The c�ranting el a perrrirt does nol �resume to gitre authont}�to <br /> violale or cancel fhe ro�-isions o�an)�other state or lucal law regula(ing construcfion or Ihe <br /> pedormance olcons�ruction. Thnt I am aufhorized by(he onner of(his property fo pedunn Ihe <br /> �rerk lor�vhich application is ntade and I cemply u-ith fhe Sfote Contraclors Latv 1827 ftCl1 iand <br /> 29G200 VI�AC. <br /> -�,L, (� �'1-- �f -/ � � °` � <br /> �Si�inutme Um., <br /> ---- -.. .--J <br />