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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��' l� - //�, �� %L .�l" <br /> PROJECT ADDRESS <br /> ✓f�� �s�� // F� �/,�y� i1�- ���;� �;� �� !_-� -�;-�-� �'.��'�'� y'> -333-� � 5 <br /> Ownor Mall Address Cily Slale/Lp Phone <br /> Tenant Mall Addross Cily SlalolZlp Phonc <br /> L-�/n„<<i. $�/5 y :��rc -J., . ,�n ��i-r.���r [ �✓���1� �.���- � 9z� -�'��'- ��� <br /> �ctrical Conlractnr Mail Address Clly Slale2lp Phone <br /> �' %��2 � f' ll ��� ��O ' <br /> � i �,�/�� J l � <br /> Slate Lir,onso Numbcr ' �� Contract Priw ol Work <br /> � �� <br /> �r' i„ ��., , . L �� (�..�, /�y.. .-/' <br /> Proposed Utic ol 13uildiny Conincl Ferson (Plan Revlow) <br /> Desr.iipUon ol Work to Du D��n�� ��. % r Y < . � � ., '�i f�. s- /�-�� < <! �n �j.li� _� Si 9�<si <br /> -- - -._-------- - � <br /> T <br /> � � yY � <br /> NOIE WIRWG IN N�:N-DW[LLINGS IS R[OUIR[D TO FEE <br /> E3G W Ri,CEWNYS, MC OR AC Cl�l3LG <br /> CITY OF EV[RETT LOCAL SALCS TAX CODE IS 3105 <br /> I hr���b� tr�Gly thdl I havv ivnd and er.�mmod tha appbcntion and Fnow thr seme l0 6e Irue end <br /> n nroc( All provis�ons o!lews and nrJmnnros pot�erninq fhis lype ol n�ork wil/bn completed <br /> �rhvfhrr sprcilicAhorein or nof. The prnnfvin ul n perniit dors nuf �resume to give aulhonty fo <br /> ��iolafi�oi cencol fhn prorisions o!airy ofhrr slnfr or locnl law rn�ulnUng conshucfion oi fhe <br /> prr/nrninrrre ol construr.Gun That I am nufhonzed hp fhe onnei ol fhis property fo perfonn fhe <br /> �+:vF IJI 1YI11CIl f1�1�111CFlNOl1 IS Iilfl(IP All(I I('tt/11(JI)'N9(II(IIP SIt11P Contrac(ors Lew iB 27 RCW ond <br /> ,'9f 200 WAC. <br /> ��' / � C/' . - /,/,. � '-- �� � -- <br /> /' �• <br /> [ <br /> _—Slgnatmc �` I � U;v�,- <br /> �: �/% �-� <br />