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i <br /> � ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, F`✓ERETT, VJA 98201 <br /> 425-257-8810 - FAX 425-257-8857— �+nv�v.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO I PM <br /> � I ��I����. ��eld w�Y (Z <br /> PROJECT ADDRESS <br /> C6� �.S�c, lo'�it �v�(,S ���_�Z�'1rV�W �ynaw�o,x� 6.i/u' yoU37 206 2Z6 '/188 <br /> Or:nef MailPddress Clty � StalaT'ry PYone <br /> Tenant Mail Adclress Clly StatolZy� Phcne <br /> �urn�ll �l�i�� y0!� 5292 �.G/✓'.��s t,,ll9- 9��J� �1Z�.s��S' 7G� <br /> ElBctricai Cor.IractOr Mail Address City StalolZip Phon> <br /> ����2NEG�g� AMG <br /> State license Num�er Con•.ract Prico of N'orY, <br /> N�9 <br /> Proposed Use of Build�n� Contact?erson (Plan Review) <br /> Description of 1Vork to Do�ene: �� /7_�YOr4�l�a� �/� �O CC <br /> NOTE: WIRR�G I�J NGN-D1NE�LINGS IS REQUIRED TO FEE <br /> BE IN RACEVJNI'S, MC OR AC CAEiLfl. <br /> CITY OF EVERETT LOCAL SALES ?AX CODE IS 31D5 '�/U��� ` � jc� <br /> I teret�y cer(iF:�ina(I/ra��e read ar.d examined L4ls ap,u.`icat%pn snd know lhe sarne to 6e true and V <br /> rorrer,t. A,'I piov�sio.�s c`la�rs and crdinance� rovemrng this tyFe of work vn'!te conpleted <br /> whefh^r spEcrGed herein cr nol. The gr�ntino of 2 perm�t dees ro}presume to,qiva 2uthen'y fo <br /> .ir,lafe nr car,cel l,tie prcvls� ns ot any fher s�a;o cr locellan•regulating:onslrucfren u the <br /> per'ormance ol ccrstrucl' n Thaf!a au;hcrized by fhe o�tr,er cl thts prcperi;to p�rlorm the <br /> �rcik/or a-hich r�ppliceG.n i made a, d!comoly•�rith tF,e Sfate Confrac'c�s La�v 79.27 RCIN ard <br /> 26L.200 V.'AC. <br /> _ /� L"i��J/ <br /> � _� %- y-o�, <br /> � Synat�- � Date <br /> � <br /> I_ <br /> � d £95LS£ESZV ��ewe� ene�S e6L 80 80 OL I�f <br />