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�ooaiooa <br /> CAR�T3LL Ii1.EC77t 1 C <br /> OS/Oi/2008 I�: IA I�A� 4253:1�i9J0 , <br /> i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www•everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM E AM TO 4 PM <br /> � I 1 Z �-% <br /> � � �a-� D�; �i,•d a r,��Y � f <br /> PROJECT ADDRESS <br /> r_� �, � �'� 1,� � l(,� l$ lol 12wM� W Cy►+��o� u� 9do3� Z06 LZ6 Y78B <br /> �b1(SJ�,L � � G . Phone <br /> ef Mall Addross ty Suta2ip <br /> Tenant �dall Addreas <br /> Cib SIa1elZ1A F'hone <br /> U(�J��.�! I Yors S 2 �-k S� �� 4�Y�� YZr 33s' 7Go� <br /> vl���GN� ��ry StalefLlP Phona <br /> EIOctr1Ca1 COnVaclot Mail Addrees <br /> v� g�gM� - �s�� <br /> ir _r, <br /> Conhact Price of Work <br /> State Uu:nse Number <br /> S� Contact Person (Plan Review) <br /> Proposed Use ot Building <br /> pescripUon of Workto 8e Done: W�r� <br /> n ev ��b o sf (-� s�2 2�o r� S e.-v,u, <br /> NOTE: BERN�CEWAYS MC t ACICABLEUIRED TO <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cortlly fhat 1 havo reed and examined this appllcatlon and know fhe same fo be frue and �, , J' <br /> conucf. A!1 pravlsions ol lows and ordlnences goveming thls type ol work will be completed � j <br /> whefhor specified hero7n or nol. Tho grdnting of a pormit doas notprosume to plve authoriry to _ <br /> violalo or concel tho visions of any ofher state or locel lew regulating constructlnn or tha <br /> perfonnance o/con llon. Thof I am euthorizod by the owner ol fhls Froperty to perform the <br /> wcrk tor which ap ca on I mado and I comply wlth tho Sfato Contractors Law 18,27 RCW end S l� <br /> 296.200 WP.C. /��L,� ,; - <br /> g-) -0$ ,- ,`� <br /> � <br /> � <br /> Date <br /> Sipnafure <br />