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C _ <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEHETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everetlwa.org <br /> APPLICATIUNS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> -1 J a W C r�� i r�J 1 C-il� � � �� <br /> PROJECT ADDRESS <br /> OWnel --�--��—� �d.ul Addross --- Cily �---�� Stale�Zip Phone <br /> C. 1 �I S�-c�X S P C 1 n o 6� C o � O� W C�5� rJ M� ��cW„tJ�f q f��S <br /> TonanlT�—T- �Aatl AAAress Clty Slato/Zip Phone <br /> u� s •33g <br /> S ,�-ml-�,-.- '�sh�.L,��� c � � (�o f'�����, S rw 1�,r. ;s� �N W��a q 1 � � s H • <br /> Elec�rir,a�CoNrac�or Mail Address City Slale/Zip Phone <br /> SN �\-�� C— S. IIOPW '�_v0 <br /> Slale License Number Conlracl Price ol Work <br /> `�A S � �-Q�.�� i O�l -- <br /> ProposeJ Usc of Ouildin9 Con�2c1 Person (Plan Review) <br /> Dr.scnplion ol Work�u Do Donc: ulr(.f(,J t Q���_�_(�+Q..��` Ovt�-�,lA� W \ � ( I�.A - <br /> —� <br /> NnT[: WIP,ING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 0[ IN Rl�GEWAYS, MC OR AC CADLE. <br /> � 1 ( � . �� <br /> CITY OF EVER[TT LOCAL SALES T4X CODE IS 8105 <br /> 1 horeby certily Ihat 1 have mad and ex�vmined this opplicu6on end kno�r Iho seme to be frue nnd <br /> �.onecf. All provisions o/laivs nnd oiAinances c�overninq this fype o!work wu!be r,ornplefed <br /> whetlir� specilieAherein or nnL The giein6ng i>/a pennd Aoes not pirswne fo give aufhority:a <br /> viulalr, or cancel Ihe(novisiens ol nny ofher state or locol law regulaiin�construcbon or fhe <br /> performance ol consfiuc6on That I nrn aidhonzod by Ihe owner o/fhis property fo perfomi Ihe <br /> H�oi6 lur �rhich app6cation is rnado and I cornpl}�wifh Ihe ;tofc Confr�ctors Law 18.27 RCl1'nnd <br /> 29ti?00 WAC. <br /> --- � � �� � � � <br /> � Siyn� e Dale <br /> � � ��-5 ��y <br />