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�� ` l,�� C cZQ� <br /> ELECTRICAL PERMlT APPLICATION <br /> CI'fY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � `3D—/D <br /> •�25-257-8810 - FAX 425-257-8857-www.everettwa.org � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ���/�r/�� <br /> i.!' I � �Q �� (? �� )1' ' .S� � /���� <br /> P(tOJECT ADDRESS <br /> � <br /> �`�a��> 30- � a-��' <br /> �t ro � +�n V t �� -tt� �� � l I� L/S �-I�,S� F. � � �t 9�.3 <br /> Owner Mail htlarass Qry State2ip Phone <br /> _��1nP �J4Sl� ��u r(> � 1 Il9 ��Y Sj �� C�;c.�c�? `�k���' <br /> Tenant �dail AdUress Ciry State�7ip Phone <br /> ��1 C�1-1 r�� � l t(_'�f�l C� I D�-' � �'�� Pr C�� �tJ� ���)�-�-v�.�`�Zl <br /> EleclricalCoNractor MaiiAtldress Ciry State/Zip Phone <br /> � n U� '� i� �I - �, �� r� ��"� — <br /> Sta e License Number Conira!Price of Work <br /> ' j-�2.r G ,l� <br /> ��L9�1�-n c s% <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descnption of Work to de Done ����—���� ����U� E�L�� �� � <br /> � � y/��l_' l (' � ��-Ll `—_l h'l�' .�/ <br /> I � <br /> `�OT= 4VIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> B� IN RACEINAYS MC OR AO CABLE <br /> CITY OF EVERETT LOGAL SALES TAX CODE IS 3105 <br /> �,v=r�bq c=rtd�tha!1 have�ead and eaam�nad fhis applicalion antl know ihe same tc be vue and �1 1�I 1 , <br /> ronect Ar�proe�s�ons of laivs and ordinanc:�s yove�nmg thrs type ol work rnll be complefed � U l � y� <br /> ,-:he:her spe;med he�ein w nof 7he y�anfirg o/a pernuf does not presume fo�rve authority to <br /> w�la:e or r.ar,ce�the provisions o/any ofher stale or local law regc'�ling cons(ruction or fhe <br /> p�rformance o/consVuc6on That I am auf�ronzed by the o�vner ot fms property to perfonn fhe <br /> ��. v:o�k ior wnich appl�ca6orr is rnade and 1 corrply�vdh(ne Slafe�onV2clors Law 18.27 RCW and <br /> 256 200 WAC. <br /> � <br /> �/ / <br /> y_�2__r. ��'1 L � ���UC� ?� - �(� <br /> . SignaWre Uate <br />