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EL.ECTRICAL PERMIT APPLICATION ' <br /> CI7Y OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRFF7, EVERETT, WA 98201 I <br /> 47.5-257-8810 - FN(425-257-8857 -www.everettwa org � <br /> APPIICATIONS ARE ACCEPTED FROM 8 AN�TO 4 PM <br /> I <br /> ��D� u h �rf' S� ��'�� l,�i'�� <br /> PROJECT ADDRESS <br /> ������ � � �� ��,� <br /> -- --- <br /> " Mxi ross C '--. .. SIMorZip Piwne <br /> Chv�Rr <br /> ICnAni PI�CrOREMC�AC�.�Addre!! "' � � C1ry �.T 31ahJZry fhonp <br /> y106 Al�lld St <br /> 6w�n'kJaw.Wn p1o24 ------ �--___._� <br /> Eledriud C�nlractor Mall Addroaa Ciry StatN'dp Fnono <br /> , ," � ��� Contrad Prlcn o�ork <br /> Slete L�cense Numher <br /> � � . �' � ------ <br /> iuposed Uee uud�ng �� Cunt� e�son (VIBn Revir.w) <br /> Squere Foolape(H residpnlial new wnstruciion, ren❑�dwl or edArtion) <br /> D6ecriPtiOn ot Wotk to Be DOne' ---,�//y.�Y�✓ ..��__�_ <br /> � <br /> NOTE WIRING IN NON DWP� I INCiS IS R[GUIRED TU FEE v <br /> UL IN RACEVNAY'S, MC UR AC CnRI F. <br /> I CITY OF EVERETT LOCAL SALES TAl(COOF IS 3105 - -----�- I <br /> i hnroby cwrfily fhaf I havo n.�ed anC examined this applicehon nnAknnw fhe sxrnn M Ae tnir, nnd � � ?(�/ - (��j4, <br /> �x�mu:t /111 piuviSionS o!Ir���nnd ortlinence�govom�n�M�s fype o/work wilf bc complufad <br /> wh�flwr specifierl IIN/NIIt O� nnf Thn prxnlinp n/n/�rmit[Mrs nuf rvsurne f0 4ivE Ouffinrtty to <br /> viul8fe or cOnCC�fAr pmvi��ion5 OI eny othc�atntrr ur luc�il law re,quPting consfn�cMm or fhe <br /> �+pAO?Rq/7fN OI COfIRI/Ilf,li,��� TAaf 1 am nulhnn�ed hy fha owner 0/fhls p�oPcrt y lu porforrn the <br /> woAr hx wlnr.lr epplicxfion IS mndg Bnd 1 r.omply wif�the Sfnte Confn.cfors Low f 0 27 RCW ond <br /> �oF ann war� <br /> / i <br /> jI`�� � ������� <br /> " Sipneture / � Date _ .� - <br /> � <br /> L--•---- _ _ _—_ --- -� <br />