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t19/06/��[17 Il?;4R 3F0559R57R <br />I�DR7FIERPI LIr,HT ��ECT <br />PAr,E �31 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 9ii201 <br />4�5-257-8810 - FAX 425-257-8857 - www.everetlwa.org G�� 06 -07 <br />APPIJCAl'IONS ARF: ACCI:P I I_t7 fftOM 0 AM TO 4 PM �'v7�'� ,�� <br />1 <br />/�'t Z� _- :� � 9� S� � 4_/__.LQ�,S� <br />PROJ[CT ADpRC33 <br />chvn�r <br />7mtant <br />� l/n rT�S r. i'h <br />Eleclrtcal Cunlractur <br />Strrir Li�:ense Nwnbur <br />L� <br />.� ,c-r ,�%a �' ___ <br />Mn Add�eac <br />Mall fWAmss <br />�� l� .c`'�f � --��. <br />Mell Addiess <br />Pmposcd 1 �s� nl [iuililmg <br />Doscriplion ol Wnrk In �r. Dono; L-.�� ✓' <br />NOT[: WIRING IN NON-DWGLLINGS IS RFqt11RF� l�) <br />ei- ir� Rncr�vnvs, rnc oi� nc cnr�i r <br />Clfy <br />Gly <br />G�ly <br />,�v s <br />Slalu'7�p <br />SlateZp <br />State2ip <br />Conirac� Price ol Work <br />Contad Porcon (Plan Reviowl <br />CI7Y oi {: Vf:lif.TT LOCAL SALES T!ix CODF IS 9105 <br />I heruby c�rti(y thal l hr�ve ree70 O�il1 Cxpntinnd flris applica6nn and know fhe same to be true and <br />conacf. All pro�islons nl Is�ts nnd urdmarn.-c s �nvnnanp tlns (t4�e ol �t'ork wil! be conrpleted <br />whether specihr.d herein or nef 1hN yrnn6ny o1 a/���nnrt dces notPrt:swne fo pne aufhonty fo <br />vrolOte or cnncPl fhe viroi5ien5 ol,any iifher stnfia ��rlur.alla«� rp[�uafhig r.nncbuCf/on pr fhp <br />pe��vmran.:e nl runsinirGr,n 7haf I arn aulhontE�d b}� fhe a�vner o/(fus pmperty to pcAorm the <br />�voi6 lor �vinch �ppLc��lian is rnadFl antl i rnrnpl�� w;m u�r. Srera Confrnclors Ln�s iN 77 RCW end <br />Z:IG 1�)U 11;4C <br />�-----��� 9 - <br />— _ s�„�,..� ,.,, — ��' — — ---- ,,o ��—�------- <br />��NMIp <br />P'inna <br />PhonH <br />� <br />L� � �L <br />FFE <br />���.�1 << <br />