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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - f=AX 425-257-8857 - www.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />; <br />/ ' , . � <br />PROJECT ADDRESS <br />' L �. . <br />a-�i ,. ��! �t ; � <br />, _ _ <br />Owner Mail Address <br />/ y /•�l <br />Tenv�i A1ail Addross <br />��� 'T � ( l l i l• �^I /�1C l ��. � �' � ���: � `, �l.'J: <br />[Icctiir,al Contmc�or hlail AJd�ess <br />� ��' � �.� i f - � � ,� � � � <br />Slalo Licimsu Numbcr <br />�' � I 1'NC'. /_J �"h�.Vl ' C. f <br />Proposud Usc ol l3uildin{� <br />Ur:;rriplion ol Work lo Oa Donn: <br />, � . -, <br />1 , r / /. , (.a.' i'' '>' . i - ( � !' �: <br />-- � <br />Clly � Slale/ ip Fhonc <br />City S�atN7ip Phonc <br />' /_�I�.�'{.I�UF;`��'�Ll/ ��'S /'��;J -/L���) <br />/ <br />CIIy Slate/Zip Phonc <br />!)�i i "� <br />l. <br />Coniract,�ric.r. ol Work <br />� �� <br />./�� / <br />Conlar.l Person (Plan Review) <br />i) il'�� "�� ���� ,, , � � �F �, �'/i"��n �7 ; �C' �'�L "_ D','�,�I�^ <br />N071= W IRING RJ NOIJ-DVVELLINGS IS REOUIR[D TO <br />E3[ IN RAC[WAYS, A1C OR AC CAf3L[ <br />CITY O� EVERETT LOCAL SALES TAX CODE �5 9105 <br />1 hi�r�d�� � rr6h l6,d i fra� �� ir.�d unJ e�,umn��J flus uppl�co6rn unJ hn��ti fhe sanie f� bo frue nnd <br />c�nro��Y All prin �si�vis ol li« ti �ind nrJin,�nces qe��ominij (his 1}'p�� ol �surk �sfN Ge complefed <br />��N��Bir� .po���Grd hen�in u� m�( The yrnn6n� 61;i porrruf does net �iesurno fa give aufhonf�� f�� <br />��iula(r ri ��,inc��l Ou� Iu��risions ol nnp ofhor sfafe or locnl lms re�ulnt�ne� canshucfion or the <br />pc�foinnncr ��l conslruchon Tlmf 1 om Fluthorizi�d bp the onnor o( fhis prrperfy fo ped,urn fha <br />«ork l�v uhirh epplic�fion is moifc and 1 comply �vith (hi� Sfnto Confracfois Lniv 1 P.71iCW nnd <br />7gti zu0 ItiAC. � <br />� -- <br />,._ . - • ��^ %,�: ,' !� . <br />�'� b��u,d-n�'_ _ _ __. ___.__ -__ y, UaI� '—'_ <br />r-te --- -- <br />i <br />, . � �i �'I.J <br />