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ELECTRICAL PERMIT APPLIC�4TION <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 />�,, � � . <br />lF c��.- �7i , ,i�,-r : _��_! <br />PROJECT ADDRESS <br />';r,:..�.; t�..r1 C�_. 1�—'.>> ��_' 1���"i I I u% <br />Owner h7ail Address <br />Tenenl <br />i)ii IvC't� <br />[leciric�l CoNroctor <br />Slate Licr.nsc Number <br />n t �� , �_S-. <br />Proposed Use af Cuildiny <br />Mall Addross <br />na;,�i nad��sz <br />(�Vc-�'•?��'i <br />Clty -- <br />Cily <br />w A �: � v la� <br />fv-_ <br />Slale/Zip <br />SlalelZip <br />Ciy� 5tate/Zip <br />s6 13, �� o � <br />Conlrar.t Price of Work <br />�i�•» �...��. -d <br />Contacl Pcrson (Plan Rovlow) <br />Ocscription ol'Norh lo Ou Uono: I N'S "-�+"-A "-.i c. � %. 5 k �� �'.�'�- �D -�, E 7 <br />�:�i��,�7 -_��ZPj, �i�- 0�-1 ��.v(= C,F l�,i�yT,-a.,y I�J���D�...1�.� <br />NOT L. WIRINr, IN NON-DWELLINGS IS REQUIRED TO <br />[3E IN f2ACEWAYS, MC OR AC CABL[. <br />CITY OF EVERETT LOCAL SALES TAX CC•DE IS 3105 <br />1 hereby c�trfity 6iat I hm�o read unJ �znmined Ihis ep�rlicntion nnA hnou� tho sanie to b� huo r�nd <br />CORCCC AII �)!OVlSIJIL� U/ Id155 und oidinanccs {7ovenw�� (015 typo o/ trork �r(ll bo conrplofed <br />u-heathe� spncilied h� ���in oi naL Thu grantinc� o! a pennR do�s nol nesume fo gi� e nuthonty fo <br />��iol.i(e ur r..mcel fh�� I�rovisions o(an}� ofher siate or local In�a mpu�nfin� conshuction or fho <br />p^�fornronca o! conslruc(ion. 7hnf 1 am a�rtho�izvd by tlre u�sner ol fhis prupert}� fo perlonn fho <br />�tork lor whir.h applicnfion is m��de nnd 1 comply with tho Sin�e Cnnfrecfors Law 1 N.77 RCW onA <br />29�.200 WAC. <br />FEE <br />Phono <br />Phone <br />;\ . <br />}�-,-s,,- -i— �j�z7 �� o �; /� l � l <br />,. <br />-- ,5�� �.�i����,- -- ------- ----i�,i�, ' . <br />