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I <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �_�y, <br /> 425-257-8810 - FAX 425-257-8857 — www.everettwa.org 3 _ Q . <br /> APPLICATIONS ARE ACCEPTED FROM 8 P.M TO 4 PM C:O �D 3 `�a-� <br /> � 7�! '� �(d »x - ,�i� <br /> PROJECT ADDRESS ��i�a�� <br /> 3 � � ���ti�� _1�'- ' '�,, �ti� /�� .�'�.1�� � � �„� ��� - -� <br /> Owner . �dail Addross 'ily o tale2ip Phone <br /> � K� / 1 `�%�,�- <br /> Tenant Mall Addross Clty Slatr!Z�p Phone <br /> ���') - <br /> ��� ���� ,�,n �a,sd `�'J�a� %�_ �;�"�x% 1Y.3 -9�., <br /> �� I , ��' � '% � , -��- <br /> Eloclrical ConlraClor / � A1ait Addiess Ciry ��� Stato2i,� Phone <br /> �./ r�. �'� <br /> --��y^��L� �yYC� I — Contr�Pric�k <br /> Stato Licvnsv Number <br /> 1 �/ <br /> � � %�U ` /�Nf/J7.�cJ�V <br /> �1= ' Conlact Porson (Plan Reviow) <br /> Proposed Use ol�uilding <br /> � <br /> Doscrippon ol WorA to Do Done: /�'iC l �� /'' '✓"� 5 f' � � <V^�` <br /> NOTE WIRIWG IN NON-DN'ELLINGS IS R[QUIR[D TO FEE <br /> DE IN Rl�CEWAYS. MC OR AC CABLE <br /> C�TY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 herPbl�certil��fhqf!hAve read end oxaminpA Ihis apPlicnhon arid hno�r flio surno to be Inur anil <br /> crirecC All provislons u/len�s anJ oMint�nces govommg fhis f}po ol�rork will Ga complolod <br /> �shother sp�cifivd lierpin or nof. T Ire pranGng cl a pornuf doo�nof prosume fo g�vo avthonf��to <br /> ��ivlefa er cancel fhe pro��isiors o!any ofher sfate or local It�n�rogulatmg censfruchon o•fhe <br /> po�/urmance o/consfruction. Thaf I anr aufhonruJ Lp� fho owner ol fhrs p�upartr to porfornr thv <br /> �t�or� lor�shrch npplication is made t�nA I compl� irifh fhe Sfefe Contracfo�s Lmc f B 2'RCtY und <br /> 29G10015'AC. <br /> � / ' <br /> �_� �- -�—� f� �i � /'�� <br /> � '. t � <br /> � Sipnatu�e, Unte , <br /> I �--- <br /> ��U3-G�1 <br /> I ----- --- —_— <br />