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ELECTRIGAL PERN�IT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.e�vereltwa.org 3 _ � s � �� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM E j D b�Z � II I <br /> � <br /> � <br /> ' k � I j, 1 <br /> , .`�C> � :2 ��� � . � <br /> PROJECT ADDRESS <br /> � <br /> J��,w-; ..+� �,rn l uf �C'_ '/i3;L /J� `/1''"`_ Sf S'�>._�1�� :?$//,5 <br /> Owne� hlailAtldross Ciry StatelZip Phone <br /> C l.l_('.,:.�' .i'l[;-I}!L i'S:� (:.1 .-�j f LC �� W �✓fi iC-'IY LV'yi _ <br /> Tenant FAailAddrr.ss Cily Stato/Zip Phone <br /> � -/-/� I / J-7 7 �- •'I.0 � . ff' <br /> �'��'�r?<� ' � ('"7"�i ' �� '� 't'/ .Tl._t � f�c�Ntti S� SC� � .L . �I <br /> Elecirica�tor Mail Atldress Ciry ' S�ate2lp Phone <br /> �- �G�L. I�L�L�l l i L. lZ _ `� �00 <br /> Sta�e Licen e Nwnber Conhacl Prico ol Work <br /> 7 <br /> �f� G:.�lc s �c�-y�L.�-/ ,'Zy�/ . <br /> Proposed Use o(Building � Con!ecl Person (Plan Review) �-'rY Z � <br /> Description al 4Vork to Ue Done: L �, ti ��z. �� � r � � ��t�_.��5 <br /> NOT[' VVIRING IN NON-DWLLLINGS IS REQUIRED 1'O FEE <br /> L�E IN RACEIVAYS, MC OR AC CABLE. <br /> CITY OF EYFRETT LOCAL SALFS TAX CODE IS 3105 <br /> I hern.by redify fh,t I hace�ond nnd eeamined Ihis npplicafion�nd know fhe samo ro be In�e nnd <br /> corror.L i111 p�owsions nllmvs cinti o�dinances yovwmny t0is type oI�vodt�vill be cornpleled <br /> v:itcth<u::puafrvd t�errin or nof. Tho yrantin��n/ri peinnf does nof resunlo In pivn,au(hD�ity�o <br /> violatr, ar r„trtce/fhe p�o:isions ol any ofhr,rstafo orfocal la�v ieguPling consfn�cfion ortlie <br /> pc�/nnnnnce o(r.o�istn¢�i�un. Tlyd I am aulhonzed by fhe o�vnero/fhis property lo pedonn the <br /> wcrl<lor�vhir,h np��licalinn is m�da rmU I crvnpty�:alh(ho Stt�te Confractors Law 18.27 RCW and <br /> 29G200�l��C., . . ' � <br /> � � <br /> �;,,-��� ;� _ l_ ��� s/ � � �na � 11 <br /> , � _ <br /> . s���,:�<<�« u�m <br />