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ELEGTI�ICe4L PERMIT APPLIGATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE�, EVERETT, \NA 98201 <br /> 425-257-881 G - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM 70 4 PM rJ',_ �; 3 .�J�, <br /> C- oC�o5 -�LI <br /> l � q �7 <br /> � ���� C),� .� � C�C1�Lli�"')O� �U� � C LtJ �\ l C� o�-�-' � <br /> I PROJECT ADDRESS� <br /> � � � � � ,�«42 t-��� ic'� � . , <br /> Ownef Maill,tldress City Stale/Zip Phone <br /> ���� � �i — �� i9 <br /> Tenant Alail Address Ciry Stale2ip Phone <br /> I'1�c� r� n �l �<�-J ��C�� . �l �o S-I�����k.�,� ZA �«�Ite��,�a< , ���, 9vCti►I <br /> EleCtrical ConlraClor Mail Address City Slale/Zip Phonc <br /> <�' _ <br /> ���c�v����k' �n1 �5 4 l� i�� � /�Sod - <br /> Slale License Number Contract Price o(Work <br /> % ---- <br /> C� �. � I ` � I C- , I : , ,_J, � � <br /> Proposed Use of Building � � Contact Person (Plan Revicw; <br /> _ �� ����-�rvl ��� ,c' �� � o � <br /> Descriplion o(Work l0 13r. Cnne: �;�� -. � j��' '�I� (� ��' ._�� � ; � /� <br /> i <br /> (-���r � ,�� ,;-� �:�lr �!� ! PO��rQ -P Pc.� �� 5P( c�� ( r� _ <br /> ; � <br /> ', i lO1 E: WIRING IN NON-DWCLLINGS IS RE�UIRE[� TO FEE <br /> I BE IN RACEINAYS, ��4C OR AC CABLE. <br /> CITY nF GVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 <br /> 1 hc��by certily Ihaf 1 have re�d and examined fhis application a;id Fnow fhe same to 6e fnie and <br /> correct All provisions o/la�vs and ordinances governina fhis fype ol«�ork�vill be conrplefed <br /> whethcrspea(ied hercin ornoL The granling ol u permd does nof presume to give authority fo <br /> violate or cancellhe provisions of any other state or local law reguluting construction or the <br /> perfomiance olConstrucfion. Thaf 1 arn authonzed b}�fhe owner ol this property fo pe�form the <br /> work lor�vhiG�application is made and 1 comp/y with the Stafe Contracfors La�v 79.�'RCW and <br /> I ,t9G.200 WAC. / <br /> : � , � <br /> � � -�, ,,�,�;i 1.�_ S��!o� <br /> SignaWre Date <br /> �Li�US VZ� <br />