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ELECTRICAL PERMIT APPLICATIOPI <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />(�� �- APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />!���t-z✓Lr-z1"C j,vl �(iL —''L47 �- I �i IZ b�-L �! <br />i� (-{� S C f�v ti o2 ��, T'i��� v� � c� �.,> v'�-� j�` ��r�� ��' J <br />�U ����� w �t- � � 2�� �� <br />PROJECT ADDRESS <br />✓ f�,2�"y fT' <br />Owner <br />�e.� <br />Tenant <br />ElecUical Coniraclor <br />h1ail Address <br />� �. C �P��-� <br />Mail Address <br />A1aiI Address <br />� <br />r G S l�v/tI d"i LL `% Gi Co I3 cl <br />State License Number <br />Sa l-�� -� <br />Propased Use of Building <br />Descriplion of Work to Be Done: _ <br />:;; r,��9. i Lr <br />NOTE: BERN RAC WAYS MC OR ACICP,BLEUIRED TO <br />\^ <br />Ciry <br />Ciry <br />StatFJLp <br />S�« <br />I-g-�3 <br />�_ ��! � �/v <br />�I U�( �'� <br />ConVact Price of Work <br />�inl�-2'T"[-} `���v'� �� SG �'1 <br />3�C�-!Zf -����ICZ-- <br />Contad Person (Plan Review) <br />( � G <br />— cic�l3 � 1 `� �7�5 ( <br />p�v<t� l'`1 S� <br />GITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />I he�e6y certify thaf 1 have iead and examined thrs applicafion and know fhe same to be true and <br />correct. All provisions o(/aws and ordmances goveming fhis type o/ work will be comp/efed <br />vihelher speci(ed herein or not. The grenfing of a permR does rtot presume to grve authonty !o <br />violateorcancelthe provisionso(anyotherstateorlocaflawregulatingpconsWctionorfhe <br />peAormance oI co � cta o�n s mahde and 1 complye�7h fhe Sfay teeCont2�cfors� w 18.27 RC W and <br />work lor which app <br />.,..- onn uinr .. <br />FEE <br />50� <br />El3ol -0�1-a <br />