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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVIGES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 47_5-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � I `( r'Lti c ���i � !�l ���� <br /> PROJECT ADDRESS <br /> /' � � i <br /> .. � .0 t > ' City, State.2ip Phone <br /> Ow`�er A7ail�ddress <br /> Tenanl M11ail Address <br /> City State/Zip Phone <br /> � �n� �� � I �P.� � ��� �DL3�� Zo99 S�2o� ,����k�c � �xs-��'71r� <br /> Eleclrical Contractor Mail Address <br /> Cdy Stale2ip Phone <br /> � �?L <br /> 7 ��0?l�J <br /> ��� `�"� 7��,/r ContractPriceofWorY, <br /> Sla e License Number _ <br /> �� i,,i � � � rl. t�c, ��( l <br /> Proposed Use ol Owlding ✓ ✓ Contacl Person (Plan Review) <br /> Descnption of Work lo Oo Done: rf I II'� !1�!1'l'-<'� <br /> NOTE: BERN RACEWAY3 MC OR ACICAB�UIRED TO <br /> FEE <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 heroby certily fhaf 1 havc�ead and examined ihis applicalion and know the same(o be true and <br /> corrt�cL All provisions o(laws and ordinances goveming fhis type o!�rork will be compleled <br /> whefher suecified herein or nol. The granting o�a pennd does nof/�resume to give authonfy ro <br /> violate or cancel the provisions o(any ofher slafe or local law re�ulating cons Wcbon or the <br /> pedom�ance o�censfruclion. That I am authonzed b��the o�+ner o/this property to pedortn Ihe <br /> �vorN(or which applicalion is made and I compl}�wifh the Sfate Con6actors La�v 18.27 RCIN and <br /> 296.200 INAC. <br /> � , (��L,��� � ���� <br /> ' - . `..J-l_.���c_ Date � <br /> /� SignaWre <br /> � �U� <br />