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Oet 09 04 05:43a <br />p.l <br />l <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 />APPLICA710N5 ARE ACCEPTED FROM 8 AM TO 4 PM - DEBR 8 CREDIT CARDS ARE NOT ACCEPiED <br />�do9 Kor.ke�Ftl.��k A.V - p�fS� NRA�% <br />PRO.�ECT ADDRESS <br />Uvner <br />Tenant <br />Eleetripl Contractar <br />Man ndar� <br />AAall Addrtsa <br />Mail Addresa <br />�ck`NN�1 /�1.� Ll� <br />State Ltcense Number <br />C�MM�cA.U.4l — <br />Froposed Use of Building <br />Clty <br />Gry <br />Ciry <br />SqtdZip �1B <br />Y2s <br />r.vfi Sdx�i 35�9'-4� <br />— s�cerza p10"B <br />I�is <br />u,.� 9�„�y 2s4 -2[4l <br />State/Zlp Ptane <br />/ 0'DO °f — <br />Contred Prica ot Work <br />Contact Person (Plan Raview) <br />Desaiption of Work to Be �one: G��� r-f � <br />it !',2rMr •�Ac��nr�Gr1 <br />NOTE: BERN�CEWAYS MC RACICAB EUIREDTO <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />IherebyceRNythatlhaveread <br />correct. All provisions of laws a <br />whether speci(etl herem or, nof. <br />violate or cancel the pro�(s�ons�, <br />fhis application and know ti <br />-overning M�s type a/ work <br />of a pemuf dues not presun <br />ate or local faw regulating c <br />izedbytheownero/ihis pr <br />ty with fhe Sfate Contracto� <br />— /o/.�. <br />fo he true and <br />ompleted <br />� authonry to <br />io/q/ y �(� � 3s� n�• r� <br />and <br />FEE <br />U � Av <br />/ � <br />Eo�1�o-035 <br />