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U <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 C[DAR aTREET, EVERETT, WA 98201 �,� 6-U� <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org � <br />aU7o 3-1 �N <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />I�li��l II�TI� 5i `�;J <br />PROJECT ADDRESS <br />(i�.'��1MY1SJ1't�tc �..�tl�, ittinrr.-Y,..FSn��li9,���J�<<� I'U I'.�c'' "'�(�(D �VPi✓ef7 wA <br />Ov.�ter Mad Address Gly StatMLp Phone <br />���i+a-� �� nr h.nl�� ii„�c✓ .�) �iun.n��;�. /�� 1'[' �r1c �3cC�� (�vGvan W/i <br />Tenanl Mnil Address ary StaieiLp Phone <br />[�Xf 5�•11W�cC I:.�{ri�i�-r�'rl7rrr l�L'.�i'I` 'Z7073 3�/iTIC r..f 9f+1 ,s" � t� N!-, <br />Glednwl Conlractor Mail Addres� City SIa1MLp Phone <br />C�k�rPl'S� GIL�(�jN <br />State°License Nurnber <br />/ f . <br />Proposed Use o11JudAui<) <br />N /S�"�-t/ <br />Conlrad Pnce ol Woik <br />r'�n�� c���r <br />Con�acl Person �Plan Review� <br />Descrip6onolWo�klo[lel)nnr /7�'�_ , _'�117,J': (tr 1�, �Il�ni� _�)i•VqX ��.� �q�.�.nl/ �7 <br />�.��i.,•rr. : �/T'via'. 4�--a( ��i•�r/11� G��nnrls .(.•r� 15 (Cc+ck 1'-P ��nr .r,�.2 5 S/'/�r <br />•. ���r�.o�. <br />NOT[ WIRING IN NON DWELLINGS IS REOUIR[D TO FEE <br />B[ IN RACFWAYS, MC OR AC CABLE <br />CITY OF FVERETT LOCAL SALES TAX COOE IS 1105 <br />1 henrhy cw6/y fhal 1 havu rrnd ond exarnmed fhis app6calrnn anA Fnnw Iho sarne In bo 6ue a�i.l <br />inrred All p�owsrons o! latvs nrrd o�Aur,�ncos .)ovenrrng fbis type ol wo�k wrll Ae contpletnd <br />wlr�fher specAmA hemm or nof ThA 9ian6ng o( a perrnd does nnf presumc lo grvo nullronty rn <br />violafe ur cancel fho �vovisrorrs ol arry o(h^r statc or Incal law rer)ul�hng consfrucGon or (ho <br />perfom�anr.o o/ r.nns,n�cbon Tfrat 1 anr oufhonzed by fho o�vner ol fhis praporty fo f�rforrn Ine <br />�sorh lor wluch appbcahon �s rnndo and I comply wRh the Stafo ConNncfors Law 1877 RCLV anJ <br />: 9fi .00 W'AC <br />l l <br />'�• ` _ � �-- �`�.'� . . <br />