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� _ <br />x �, l; L % <br />PROJ[CT A6DRESS <br />ELECTRICAL PERMIT APPLICATION <br />CI �"Y OF EVERETT PERM17 SEFtV�CES <br />3200 CEDAR STREET, EVERETT, N/A 982Q1 <br />425-257-8810 - FAX 425-257-885' — www.everettwa.ory <br />APPLICATIONS ARE ACCEPTED FROM B AM Tt� 4 PM <br />Jr ;%l 1✓� <br />;lJt sTfFti �.i;;.s �+ MG�i r,�C C ��� �0 <br />OwnCr Mail Address City <br />� �: <br />Tenanl <br />Mail Adtlress <br />C�ry <br />:;latc!Zip <br />State/Zip <br />a - s -oq <br />Co IDa�-oaF <br />Phone <br />Phone <br />j�. C-. ��: ���S�.J l;�C=cTizrc f•vL .s3LZ 13z."-/ST_ S�c,./ L�i�/�,'or,<;e,G� <br />Elecirical Conlrac�of Mail Address Ciry SlatelZip Phone <br />�Cl'E%f_ l c�ov J3L <br />��Stale I_icense Number <br />G����� �/"'�� �� � ��� <br />Proposed Use af C3uilding <br />_l o�o. <br />� <br />Contract Price of Work <br />�A✓� �r r Gd� 5��.� <br />Contact Person (Plan Review) <br />Descriplion o( Work lo Be Done: ��� ST �'/�� �' E 7 � �/4'13 . <br />NOTE� .;.IfJ� IN iVON-DWELLINc;:; I', I�FQUIRED TO <br />[iE IN RACEWAYS, MC OR AC GAk�LE. <br />CITY OF EVERE7T LOCAL SALES TAX CODE IS 3705 <br />fhat 1 hav�� i��ad t�nd exarnined tlus apqlication and kno�v fhe same to be truc and <br />visions o//,m:s and oniina^� �s governmg (his type ol wo�k will be compleled <br />ed herein or noL Tlie gra � ol a pernut does nof presurne fo give aulhonty to <br />:1 fhe pro��isions u� am� oUr�r §tate or local law regulafing consfruG�ai ar fhe <br />� consfruction. That 1 am aufhorized by Ihe o�vner ol this property to perlorm fhe <br />applicafion is matle and I compl}� �vifh fhe Stafe Cunlractors La�v I8.27 RCW and <br />� <br />� i.. � . .� �—__ <br />i- <br />,. �—•�� �.. �-U�--� 7 Q — � � <br />FEE <br />���L�2' U2, <br />