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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 � l. � 2—+�O <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org �� p 1/ ��� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�- � / <br />�� �� S 17��cD �' Soiv l�c �; <br />PROJECT ADDRESS <br />Owner <br />� <br />� n <br />GL � �tiflLLGI���L�_ 5 <br />Mail Address <br />Tenant <br />(�� '� � t <br />l� �_�-,-- <br />Mail Address <br />Eleclrical Conlractor Mail Address <br />City <br />City <br />� � <br />City <br />(, �l��t�'�{PSC�7 Z.I�S"� - <br />Slale License Number <br />��'l !'�A �'I 1�-c� �' '� r �'t c,< <br />Proposed Use of Building <br />Descriplion of Work lo [3e Done: <br />r <br />NOTE: BERN RACEWAYS MC OR AC CABLEUIRED TO <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />State2lp <br />Slale2ip <br />Phone <br />rnono <br />,� �1�.�- �06-7�zTv <br />Slate/Zip Phone <br />� � C� <br />��' r�� -- <br />Cbnhacl Price oi Work <br />Conlact Porson (Plan Review) <br />/� _ � <br />11� l _ l�Lil�I f <br />1 hereby certify thaf 1 have rend nnd examined fhis applicntion and kncav fhe sanw fo be Iruo end <br />correcl. All provislons of lau�s and ordinances goveming thls type o! u ork will be completed <br />�vhether specified lie�ein or noL The �ranfin� of a pernut does not presume to give aufhonty tu <br />violate or cancel the provisions o/c+n}� other stato orlocal law regulnting consWclicn crOio <br />perfommnce o/ construc(ion. That 1 am authorized 6y the o�rner oI this property to pedomi the <br />roork Ior rvhich application is mado and 1 cornply wilh fhe Sfale Contmctors La�v 18.27 RCW and <br />296.200 VVAC. <br />\ <br />� ♦ ,_ <br />._ . . J :` `..` <br />FEE <br />F I c.,� i I- � i�' <br />