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( <br /> ELECTRICAL PERMI'r APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEFtETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—www.evereHwa.org <br /> APPLICATIONS ARE ACC[PTED FROM 8 AM TO 4 PM -OEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> i�-�l � � 1r�', i t�t I -I�,'r'r l�. �(J — <br /> PROJECTADDRESS � <br /> � -11' I,l", � ' :I))� �iLll �.)i1h9CKa. �jbi � �.i r: l•N . H '�.f _ ��/ -SLl� I f� - il_�„� <br /> pw�ef MailAddress Cdy State2ip Phonc <br /> ( .�.. , h' �� t��-� '�i7i �tii•i i�i: ,,.. �� t� L „ ,:���r� e.'�� �iY�t;i ' <br /> Tenant Meil AdAruu Ciry Stalo2ip Phone <br /> I 'tl�.� � ..�� rl���l ' �' �li . ' -;�1 � � II � i�.�i. '�litlr_' il ! : �,��,. _ /.j �. � ' 'Y-':":.- <br /> EleCfical ContraGMf Mail Addmss City � State2ip Phonn <br /> ! ! �' -� II �"� l _ '1' ;1'Y � � It' :��c <br /> Stata License Number Contrad Pnce ot NMrk <br /> p9n1� ._C. •[,c <br /> ��l I ! [ ( ) <br /> Proposed Use of Building Contad Person (Plan Review) <br /> DescnptionofWorktoBeDorre: '��ir �� •� -�� c+�"� � �+�' � � n�<� <br /> NOTE: VVIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi/y fbef 1 heve reed end exemined fhis epplicetion end know f6e seme to be true end <br /> correcf. All provisions o/lews end ordinences goveming fhis type ol wrork will be completed <br /> whafher spea/red herain or nol. The granting ol e permd does not sume to give euthonty fo <br /> violete or cencel fha provisons ol eny ofher sfete or bcelleN�iagu eting conshudion or tha <br /> per/ormence o/rnnsfrucfion Thnf 1 em autbonzed by fhe owner o/this property to perform fhe <br /> work tor which eppGcetion is mede end 1 comply wdh the Sfete Contrectors Lew 1827 RCW end <br /> 296200 WAC. <br /> 1.,, !� � �j'��"/ ''l i �;:� i � <br /> Signatmo ' Deto <br /> � �� <br /> � , 1� =� - / / ,S <br />