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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES Q <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425 257-8810 - FAX 425-257-8857 - vv\vw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />-)o / R�r C-A �y� f S�If� B <br />PROJECT ADDRESS <br />/ (%/C#(./r✓ MA2K <br />Owner Mall Address <br />City StatelZip Phone <br />IvoAt <br />Mall Address <br />City State/Zip Phone <br />1 enanl <br />.__.�., %rs x 31� d✓e- S S�.a6rC� �•�^ 9d�fJ (2o6J8;7T-f1e <br />Electrical Contractor Mail Address <br />[�rlcfiT�✓r 9s-4CIr <br />State License Number <br />/Ztr14/L <br />Proposed Use of Building <br />City State/Zip <br />42 Cop <br />Contract Price of Work <br />5rt116—F <br />Contact Person (Plan Review) <br />Phone <br />Description of Work to Be Done: <br />2iv6r4`1 sw;rcyes Bn/D 1,;�;rrs To TIUvrJ <br />4A7//b100Fi. /D 02X[fr r/mo'e_6Ce"y L! �ceOlale z dzcrlF� <br />NOTE: KERN RACEWAYD A C OR ACCABLE. <br />REQUIRED TO <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read <br />correct. All provisions of laws e <br />whether specified herein or not, <br />violate or cancel file previsions <br />performance of con �f �o�ois fill <br />for which app <br />296.200 WAC. <br />this application and know <br />nnvrmina this tune of Wei <br />to be true and <br />completed <br />e authority to <br />tion or file <br />e perform file <br />8.27 RCW and <br />FEE <br />t) � <br />