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E� �CTR��AL 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 8 AM TO 4 PM <br /> �Q�I � ac �'P� ��1f�_ . <br /> PROJECT ADDRESS <br /> �ICYt'1NC� �S . ��`�Io� "��AC�� Y�l�� �'�X'C° I' �^� I�I �`'v�5�9 . <br /> Owner A9ail Address City Slale2lp Phone <br /> Tenanl Mail Address City Slate2ip Phone <br /> �/.21SSirJ t-lC�c"fCiG �c7 lDtl�C �� /.�P �1 W� � �—"�-+ yc�S��S'� o7'S� � <br /> Eledrical ContraClof Mail Address Cily SlatelZiV Phone <br /> �C�aSsE�� 153 ��� � /000 � <br /> State License Number Contracl Price of Work <br /> ��Ip� ��G,IP� <br /> Proposed Use of Buildinc� Conlacl Person (Plan Review) <br /> Descriplion of Work to�e Done: � �Q.�) \ .�.(b,w,�� 4�"y� (-'I `1/ 1� l I NC�a� f � � <br /> ���ON SC�N�� <br /> NOT[' WIRIN�' IN NON-DWELLINGS IS REQUIRED TO FEE <br /> i BE IN hACEWAYS, MC OR AC CABLF.. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �/ P ( / <br /> I hereb}�certil}�Ihaf I h,3t�e read and examined this ap�nication nnd kno�v the sarno(o be We and lJ�UJ -U� T <br /> correcL All prnvisions oi laws and ordinances goveming this fype oI work will bo complefed <br /> u'.;e(her specdied herein ornoL The grantin�r ola permit does not �resurne to give aulhonty fo <br /> violafe or cancel fhe �rovisions o/an}�ofher slate or local la�v rec�ulating const�uctien or fhe <br /> perfom�ance e/cons�ruction. TOaf 1 am aufhcrized by the o�+ner of�his property(o pe�lonn Ilre <br /> ivo�F!or�vhich application is ntade and!.:ornply�sifh the Sfafe Conhacfors La�v 1827 RC W anA <br /> 29G.200 l4iAC. <br /> ���� <br /> "�`�--- g-i� - 1 � <br /> sl9na�ure ua;o <br />