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• 6'�� • <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9gzp� <br /> 425-257-8810 - FAX 425-257�8p57 —v;v,�a;.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PtJI <br /> / OSDD �Ver�,�n Wu � <br /> PRUJFCTADDRESS <br /> Owner L1z�l AG9ress � ��i <br /> ' Y Slale/Lp Phcne <br /> �}¢� C 1v�SS 0.y1 I 0.s0 O �v<r <br /> n Wa. �� c,c�'r txl n �i �fa�� <br /> �enanl L:al hCCress Gly S�a�?IZip Phone <br /> P�rn{�r �/eckic� -Tr�c. i38y5 R-e��r j�� Q,w � �g��o,, 360•?5�•i,3oa <br /> cfectocal Ccntractor i <br /> L�a.l Adtlress CiIY �ta�e2p p <br /> hon•_ <br /> PO infe� r��8- .� � � �6, 7�`� <br /> S!at?L�mnse N�:mher Contrad Pnce ef Vdork <br /> � '. <br /> c• <br /> Prcpcsed U;e r,f 6wltli^g Contact Person (Plan Review) <br /> ���� 7�kVi4 ' <br /> Description ol VJor4. to Oe Done: ti�� �L n �� <br /> CM�`.t,�v7'.�o c�QR C�e�n,rn <br /> __ <br /> NOTE: WIRING IN NON-D1h'ELLINGS IS REQUIR[D TO FEE <br /> BE IN RACEVt�AYS, fnC OR AC CABLE. <br /> 35 � �o <br /> C�TY OF EVERETT I.00AL SALES TAX CODE IS 3105 <br /> I here6y ceriily�haf I havo read and examired fhis applica(ion and know the same fo be Irue and �I 3�� ' V�p� <br /> conect. All piovisions o/laws end ordinances govornmg fhis type o!ivork�vill be comp'efed <br /> whefher speciGed herein or nof. The granting of a permd does not presume to give aufhon(y fo <br /> peAvmance ol consPuct�oo.nThal l am�autho�ized by Ihe�o�v e9ol fh sgpropertyrlo�p�ohm the <br /> work(or which applica(ion is made and I compty w,th the Sfafe Confrar.tors Lew 18.27 RCW and <br /> 296.200 WAC. <br /> �%�� <br /> SignaNre � Oa�^ � � <br />