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11/05/2014 0: 56 d5708 P. 002/002 <br /> ELECTRICAL ERMIT APPLiCATION <br /> CtTY OF EVER TT pERMIT SERVICES <br /> 3200 CEDAR S EET, EIIERETT, IqIA 98201 .- • <br /> , , . 425-257-8810 - FAX 42S2S7-8pS/�.www .�verariwa,or9 . //-.-0 5--1� <br /> i C l�fill-0�4�f •. <br /> I�L:Z -zs � S� ao� <br /> I PRO.I�CT ApDRESS <br /> r � ,� �'�°��3 �qyy <br /> OWper - Mail Atldress � <br /> � _ � ' s���P � P�one <br /> Tenant . . . . . ' Mnil Atldiess � . . . . .. — <br /> , � . � Gb .. SWtelZP 7 O Pnane <br /> • � � _f <br /> , - � - 2l,�, ��� , <br /> �Eleqlnt81.C4�V9dor �� � '�:FAaIFACq�ess : '. ChY . � ' � StetelZlp� � <br /> . 1';,� .. . . : � . Pfwna:��_ <br /> -� , , , l ; or � � � <br /> SWteLicenseNufiber(faqu��d)' �: ; . f'.. s, . <br /> ,:. ��. (g������� <br /> G{y of Everett 8usiness Licensa Numoar(�equired) <br /> . ` �• •. �����''L�.a[Ql_���/�' <br /> Praposetl Use oF uilWn9 :; : � ": �PfUract Pnce of Work - <br /> . "' ��: . . <br /> . . . . ' _ . , r' ' J . . . � <br /> . . _�'� . . . . <br /> Squdro Footaqe(If re5idenUql nalvmr�uuc�ion, remudef qr �p� : ',�,,q��Pe�����Numher/Email � <br /> •.�: <br /> , �- ' . <br /> NumDer of devicee(If low voltaga? ; ` ' � - , <br /> flascnp4on or Work b 9e Oonp'�.' ' <br /> 4., ;. � _ . . <br /> " - . .. . ,;n-.:.,. _ . <br /> , . ,; <br /> . '. :,' ',-, . 'l F� <br /> C�TY OP EVERETT�.OGAI.SAL.ES TAXCOpE IS 310b : � " � <br /> . . . . . � : A '��,q t •. � . �) ../ <br /> I nareey comfy thpt!nqvo rond Anq araminad thrs appllce6on 1uwW U�a se�lo be hue gnd `a�/� <br /> cnrroa. a11 Provisrons ollqws prrq adrnances goveming fNs ql�yp��.pg���p <br /> wheMorapec�hed Aeroin or nat:' Tho grsnling oJ a pertnit dt�ae pr�syq�g�p���hRrrty to <br /> vio/ato br concel!he provisior2s cy any otherstato alocallaw PERMfTS � <br /> le6r�gca,sVUCGanatho � � � ✓ �� <br /> performancv oJ conslruclian. 17�At/um auMonzed ey t.he aw �y tAis pApp�y�p��p�d <br /> 96.yQp yy� �Plicqdon is rt1Ade and l comply with tho S�eJe L�q�{�y�g,2�RCW entl � � � <br /> , � . <br /> . �.� . - . �/ � /d . _ .. . � �. . � �� . �. <br /> .. Igfldl4f@' . . . ' . . . . <br /> � �� <br /> ' � , � . .. �. �;. . . . .. . . . <br /> iSEaaaD6�viar . , ' . .. � . � � . .. <br /> cv <br /> �. . . . ' - .. ����• . . . . . . . � . � . <br />