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ELECTRICAL PERN�IT APPL.IGA�f�ON <br />CITY OF EVERETT PERMIT SERVICES <br />320C CEDAR STREET, EVEFETT, `NA 98201 <br />425-�u7-8810 - FAX 425-257-8857 —vnvw.everettwa.org <br />APPLICA?IONS ARE ACCEPTFD FROM 8 AM TO 4 PM <br />,� ,, � <br />._, �`. ;I�y'! .9��c �!t���Fji_`� �Gc7�E <br />-i f-1 <br />PROJECTADDRESS <br />� � <br />-, �„arE .��D� L'��,�Y �Te /«x> <br />:�1=vi Dr-r�. fhF.�aL C; - � <br />Owner ldail Address City <br />--'��7 � — Z:�� <br />-- a <br />J � <br />� „��te17 <br />S�at=2ip Phone <br />Slate/Zip Phone _ �, _, <br />Tenanl MailAddress �'ty -'iZ•�=G 1 � "� ��G- <br />l O %JOX �?` /LiFi' �a%� �fi� G!J/�F- �t/�J.� <br />,7��_�q.�.�:i� �/�CT/2-IL Ci'y SlalelZip Phone <br />ElectricalConlractor MailAddress i <br />���IZha6.,�lEl c'-�JGL <br />State License Number <br />C%f��=i LC <br />Proposed Use of Bui!ding <br />Square Footage Qf residenlial nee+ consiruclion, remodel or addition) <br />-!�. �._ -.., i i_ . � �.1/l� <br />Descriplion of Work l0 8e Done: <br />NOl E: BERN RACEWAYS MEC R ACICAB nUIRED TO <br />C1> <br />/�� <br />Contrect Price of Work <br />Contact Person (Plan Review) <br />CITY OF EVERFTT LOCAL SALES TAX CODE IS 3105 <br />I hero6y certify Ih�t 1 have read and examined !his vpplicatian andlmo�v fbe same (o be tiue and <br />cer�ct. A/l p�owsicns o(laws and ordinances goveming this type oI �rerk w.�ll Ge. completed <br />����f/ier specilied herem or'not. 7he granting oI a pennd does not�resume fo give aut/tunty to <br />�:Ie crcancel the provisions o/any ofhersta(e orlocal lar� regu almg consfruction orlhe <br />, lormance el construchon. TAaf 1 am authonzed by Ihe o�rnero((his�ropedy (o pcAomi the <br />;; /or e�hich application is made and 1 comFty wifh fhe Stafe Confrac ers Lai�✓ 1827 ftCW and <br />�; 300 WAC. , ,� <br />'��i�,:4 l�' � - _ � - '`'_/`' — <br />_ i)�te <br />-- Siqn.?ture . __-_-- <br />FEE <br />� �; � <br />�� i <br />t1�,���-�i �_ <br />