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D1RP.-23-2�11 1��25 FP.011:C&M HERTING 425-745-1344 T0:14252578857 P:4�4 <br /> ( <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR S7REET, EVERETT, WA 98201 3 _� �„�� <br /> 425-257-8810 - FAX425-257-8857—v�nvw.evereriwa.org <br /> Gl/a3�0� <br /> APPLICATIONS ARE ACCEPTED FROM e AM TO 4 PM <br /> �� 2 ����G1I�Y12 ��i.0 � <br /> IPROJEC7ADDRESS L <br /> Pa�,i �P��o�un ���i �to�' �PfS ��h�,rn ��-Qgoc ► � 2 � � <br /> Ownor ldnilAddress Cily Slote2ip Phone <br /> �.�� �j7_ 1, ,�., �P,�.�R. A�r,�� S t� �/ �t1� � $2b( 7(vbqZCO <br /> Tenanl tdailndtlre3e Cily StaleR�p Phone <br /> L�iYI �IFrA�n� )��G I�I`� ����ac�c�c�� �/ l.�R-� S?�I �2S 2 .`�I � <br /> EI0CMC71COOlfACtO� MailAddress City Sin�^lZip phanc <br /> c�n���M uaa� Q� <br /> -..-1,� <br /> SlTto Ucense NumDer Contraa Prtce of Work <br /> i <br /> Prppo:tcd Use of Duddiny Conl•acl Person (Plan RevifN') <br /> Doscrlptlon o1 WorY,ro�e Dona� InS�I I � (� I� ,V� ���'{' P(� � C� �� r <br /> i �-l�.r�dl�e� <br /> � <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> �E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> 1 hcrebv ccr,f'y ihat!havo road and ex�m�n�d this appl+cation and know the same ro be true antl ;%�I��� ,_ ��y <br /> cerrocf: A�7 provlsions o)fon�s snd ordinances 6ovemmn tnis type of woiN»,i!bo comp/eted �__}, <br /> whi�6Yor speciGcd hcrafn ornot. The O�mnhng of a peimR does not nrdsumo to give authonfy fo <br /> I vi01ele o�c�ncef fhv prov,�s�ons oI sny oLtior stata orloca!lawrayu/atirg construchon or Mo <br /> pedormanco olcons7uchon. TAef 7 om autfrenzed by tAe o�vnerof lhis proFeRy fo vodonn(he <br /> �mrR for t��hloh applrc+7tion rs made and!co�vvpty�ri:h tha State Cor,f;atlors Laa�18.27 RCW end <br /> iP6.200 WAC. <br /> i <br /> I � 12�Q�u,+pn�C 3�23 -� I <br /> si miure / �f oate <br /> C� <br /> I <br />