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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />42�-257-8810 - FAX 425-257-8857 — www cverettwa.org <br />APP�ICATIONS ARE Ar.CEPTED FROM 8 AM TO 4 PM - DE81T 8 CREDIT CARDS ARE NOT ACCEPTED <br />_ I�' L�1 � u C: `L� Sc.� <br />PROJECT ADDRESS <br />`>Cu���.i� I�����•� C ,, n �_ 204 -(�:,, <br />� --- - ---.:—_ I S Z 1 I l, � � � Sc.J ��,�� � c.�Jn �) x �o �/ �, ����; <br />Uwner Mad qddress C�ty SIaIMZip Phone <br />Iv/1� <br />Tenanl <br />�LLI�Y?f� ��( <br />f_Icctrical CoNractnr <br />Maq Addiess Cdy SlaleqiP Phone <br />�-(� 5 <br />i;ic'c LL(� 1�'ilj ��e� �(��- �'��CUu� 1�;/� ��Zh�� 5loL177� <br />Mail Addmss <br />L�� r:.u� ����; �; r �: � e_ <br />!ila�t+ 1 ICeI15n NURib9r � <br />Pioposed Use ol Oudduig <br />hi��:rn��Lnn ul Wurk �n Hn Uane ,.�. /�.) 1 C1 _�� I�.� �� <br />NOTE WIRING IN NON DW�LLINGS IS RGOUIRED TO <br />LiL W RACENlAYS, MC UR AC CAL3LE <br />CITV OF [VCf2ETT LOCAL SALES TAX CODE IS J105 <br />Gly <br />Slate2P Plwne <br />�a5���.c.�� <br />Contract Price of Work <br />/vi �� <br />Conlact Person (Plan Rewew) <br />� C/�C (.( C i <br />I henenV ��urt�lv lh;rt � have n�:id rind carnrnnrJ lhi5 oPPl�cahun and Fno�v (hc sarne fo bo true and <br />rnnr,�l All hri�visi��n.r nl I.i�Ps pnd nrdrn;m�-rs p��ve��nm�! Ilus fypn of wU�N �cdl bP CwnplefP.d <br />�inr�lhur spuc,hvd hu�v�n ur nuf Thv gr;mlun� ol a purrruf dor,s not preswno fo yrvo aufhorRy fo <br />viol�ile� �ir ernrecl !he p�uvisnvis ul,�ny ofhnr sfafc ur locrd lenv rr.gulahn� cons6uc6on oi fho <br />��rnl�innm�re nl consbu�•hon 7h:if I,im nufhonT,rn b fhc o�vnm ol lliis Properiy fn perform tho <br />nnrl, !or �vhich appper�l�un is rnnde ;�nJ I comply wiL; fhc Sfalrr Cunfracfors La�v f B il HCW enA <br />79G 2UO IhAC <br />'�:�Ilte_ .bCcr��L� it� , 3/� �lc, <br />FEE c�i ���, <br />1P�L <br />l.� <br />