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ELECTRICAL PE�MIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEF2ETT, WA 98201 � � -1 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org ; ' ' -J <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�-�7�1.��1 �s � �, �� � � �-� <br />PROJECT ADDRESS <br />�����..�aU,e�� C�C�l�cc�ot'> I�J I�X't 1c��(3 1-�ertfF L✓A `/c�.'2(3 `llsfilcy9,'y <br />Own�r htail Addr�sa Clly Slale2lp Phone <br />Tenan! <br />[loclric�l Contractor <br />��lJ��� <br />Slala Licanso Numbcr <br />A1ail Addross <br />Mail Address <br />Cily <br />Cily <br />Slalo2lp <br />SIaIcIZip <br />_ � �_ <br />� (JC� <br />Conlrnct Prir.� ol Work <br />Phonc <br />Ph�no <br />� _- `/LS' c�/ �U )Ly <br />� ( R _ /���t f- (�,ecK <br />Proposed Uso ol Buildlnp Conlacl Person (Plan Rovicw) <br />Dr,sr.riplion ol Work lo f3o Dono: ��a� �,�5 k1 1��t { �-_� •= .._- <br />NOTL: WIRING IN NON-DW[LLINGS IS RE�UIRED TO <br />f36 IN RACFWAYS, MC OR AC CAF3LF. <br />CITY OF [VERETT LOCAL SALES TA% CODE IS 3105 <br />I hrmb} avli/y th�vf I hatr �end nml cxaminod fhis appllc <br />r,onoii All piarisions o!l;�ns and orelinoncns �ovrminp <br />�vhirfhrr spocilicAhomin ornot. Iha yranfing o(a pennd <br />riMafe cn r:ruicel fhe iruvisions ol nny o(hei sfnte or loca <br />pr�formrim;c u! rons{ructian. That 1 am nidf�orizen by fh� <br />worA !ur �vGich npplicn(ian is nt:ido nd I comply �vifft fhe <br />7!76 L00 INAC. �_ - <br />�� <br />:;�:;: <br />a(ion nnd 6ne�v fhe snnta to b� f�uv anJ <br />this fypn o/ �tork n�ill bo cornplrtrJ <br />does naf nesume 10 give aufhorify L� <br />I lew re�u��fing conslrucfion or fho <br />� ewnor o/ Ihis p�uperty fo pert�mi fhc <br />Statc+ ConYnclrns Lou� 1f3.27 RC11' and <br />�/ 4 2� � r <br />ree <br />Ll,���cy- Lc_� I <br />