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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �� �2 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � ' <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org C ���,..dD�j <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> for,v.er K�� Bnn� 11�21 cdt�Cerr:w A�e. <br /> PROJECT ADDRESS <br /> ^ o.el+ �1e1 cgoae S�r��1 E.�ue++ i.1A- 98L8� _ yzS-2S7-889(0 <br /> �� ���y State2lp Phone <br /> Owner Mail Address <br /> Pinre++ V�\� ' � ' �o We�-ww '� A�t £u�rt�l-� � wA 98to1 Ly?s tS?-GT4o <br /> Tenanl Mail Address ���Y <br /> StateZp Phone <br /> C�� e vo.�e ac� i<S -F»..wi-. <br /> Eleclric I ConVaclor Mail Address <br /> Clty SlalelZip Phone <br /> �1 00 .o� -- <br /> Contr c Price oi Work <br /> Stale License Number <br /> T�12a}PC Ed..cc..4�ov� Cev��u. _ <br /> Coi:'-t Person (Plan Review) <br /> Proposed Use of Building <br /> \ wur reaa�rew.a.tii1 i�'� Q.�+ 11��ir�t �av� owd. <br /> Description of Work to Bo Dono: �n,1� ` �Fb <br /> d.�.� �'L2h��r �v���.�e �s Y� .' � <br /> - } li OS 0.� \2� Jo'l�� S. a la `7��$e . <br /> �u�� hea.-�2r ic r4a�a a{ (oq ,y aw�s a� 7p8 Vo��3 3 �hnSe — <br /> NOTE: BERN RAC WAYS MC OR AC CABLEUIRED TO <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �IZa2 _ U U S <br /> 1 hereby certi(y that I have read erd examined fhis applicalion and know fhe same to 6e fn�e and <br /> correcf. All provisions of laws and ordinances goveming this type of work will be complefed <br /> whether specified herein or noL The granting of a permd does not presume fo give aufhonty to <br /> viola(e or cancel the provisions o/any other stale or local law reguleting construction or fho <br /> perfomiance o/conslrucfion. Tliat f am aufhorized,by Ihe owner of this�roperty to perform fhe <br /> work lor which applicafion is made and I cnmply with fho Stafe Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � 2�, I,Z <br /> ' Sir�nature <br /> Date <br />