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r-- -------- - <br /> I ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> � 3200 CEDAR STREET, E`✓ERETT, WA 982U� <br /> I 425-257-8810 - FAX 425-257-8857 -www everettwa ory <br /> �� APPLICATIONS ARE ACCEPTED FROM R AM TO 4 PM � <br /> I _�/ �// '! I /C V�C, l � �� <br /> I PROJECTADDRESS : � � > � <br /> � y„t� - )S%- /fi�'-� � <br /> � � n � i�' ��„� �_ � uz�cll C4,'ft _ <br /> , <br /> �'� �� � Z{'� P/� (J{YIC'S ���� . 9lolalZip Pnone �� <br /> � Owner Mail AUdreSs ���1 � <br /> S �� StalelZip . >. Pho��Y <br /> Tenant <br /> MallAodre•.:� �'�Y �,f3 3�G Ol.� <br /> I,�✓r t�u,c�� ��.y f����; P a ��,y �1��� l C�/�.��1,r,��c I N _ Cc/� Y�u %�__-- <br /> ' ElecinCal ConV2CI0f P A ACtlress <br /> C.itr � s�a�e�zip rnuno <br /> ,�� �,� �r��N� v o a �=/� �o�«r��P,����W��k <br /> II Stale License Number <br /> ���"r� C� —�— Conta.^.t Pe:son iP�an Rewe:�s�� � ' <br /> Proposed Us=of Building <br /> � / I /� � <br /> IDescripucn of Work to Be Done �l�v��T� � —`�'�-`'-_�'-"L���—S.��--- -L�-��L�� � - <br /> ' __ _._—_— __ <br /> �I'I FE E --�� <br /> NOTE. BERN RACEWAYDWMC OR AC CAB�UIRED TO <br /> I <br /> �' CITV OF EVERETT LOCAL SALES TAX CODE IS 3'105 � <br /> . t�ereby certrly(haI I have read ond e.eaimned this applica6on and know fhe same fo be bue.r�-.: <br /> � cnrrecf All provisions o(�ews rnd orzLna�ices go�eminq th�s type c(work wd�be comploted <br /> � wheUiar sVec�fied horem o�no[ The granting o�a permd does nol presume fo grve au(honty Ic <br /> vrolafe orcAncel the piavisions ol any ofher state orlocal law regub6ng consfruchon��fhe . <br /> IpeAormpnce o/construc6on Thaf i anr authonzed Gy the ownei ol lhis Uro4erty[o pe�forrr� Ihe . <br /> I 296k200�WAC applioe6on is made and I cornply wifh Ihe Ste(o Cunfrac(o�e Law �8 27 RCW and <br /> r <br /> ��4 yvvu w � � �' J / � � � <br /> '. Siynature Datc �j '� <br /> I � f� � <br /> � Il� <br /> U <br /> � _ _._ -__—.-_ <br />