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� ` <br /> ELECTRICAL PERMIT �PPLICATION , ���-I <br /> CITY OF E`lERETT PERMIT SERVICES �j � ' <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICAT�^NS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> IOI�11 Ei�►2�,rt,C� (�1�.1 <br /> PROJECT ADDRESS <br /> �/ �/LS � <br /> KL�rr� ��v�� ���1� Ev�=�,?,��_�� WA 94Zo`I 3ss-��oo <br /> Ownet Mail Address City State2ip Phone <br /> _'il4 W11= <br /> Tenant Mail Address City State2lp Phone <br /> ��• �61C fj�'/Q <br /> �Aca��o� 1s4�++�,�Ccrc. ln�v�rr�:zuE r,J'A qa'o72 S�Z�-�/�l-sao� <br /> Electrical Contractor Mail Address City Slate2ip Phone <br /> `I�i��FCLO�Iu DC� � IO,oau <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contac!Person (Plan Review) <br /> � � ` (� <br /> Descriplion of Work to Be Done: KC'�[}Zf> —�-f ns L-X�Srr�L_ C'n tiT'rv—� �1 l`T'IC TU11k <br /> ��rn.��t�F n�- <br /> I <br /> I NOTE: V�'IRING IN NON—DWELLINGS IS REQUIRED TO FEE <br /> BE IN FcACEWAYS, �AC 7R AC CABLE. <br /> CITY CF EVERETi�OCAL SALES TAX COOE IS 3105 <br /> 1 h�reby ceRi(y that/nave reao ana =xamin=d this application and kr.ow the same to be true and <br /> cor�ect. A!I proiisions of!aws and crdinances govemmg this f�pa cf work wdl be completed f�U'"+�2—CI�FQ <br /> vihether soec�fied here:'n or not The grarting of a perm.d dues nof resume;o give authonty to <br /> v;ol�te or cancei the prnvisicns o(an�otnzr state or local law reguPfir,g construction or thP <br /> w rk lorawh ch apo/c�atic��is made and I c��mply w th fhee t[e Cont a�c'orsnLawy18.2 RCNtand <br /> 29ti.2i70 W�C. <br /> � �� � �// <br /> ����-- , % ��% / _—/3 D <br /> �Signaicre Date <br /> / �— <br /> � / <br />