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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVEFc�TT PERMIT'SERVICES <br /> 3200 CEDAR S7REET, EVERETi, WA 98201 � ����-� z- <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org �1 �.7✓D_7� <br /> APPLICA710NS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> `7 a N �-f s T��l. s c� s E' _ <br /> PROJECT ADDRESS <br /> � - <br /> ' � I 4,�9 �a� �tsri� s� s� E�e�N wA �'8� �� 3 <br /> _�ar ' � �ti State2ip Phone <br /> Owner <br /> Mail Address ��ty <br /> Tenanl Mail Address <br /> Giry State2ip Phone <br /> Saz E�1� . � Nto-::.�.� w►a 98a>a 3lao �5 <br /> v 5 ),�.,�,�.y�q Ct�bi r� I�lee..�� on '7 <br /> Elednwl Gontractor <br /> Mail Address City SLP�e��N <br /> 6siJ- rbsN���-p � _ °� <br /> GoNract Price of Work <br /> Slate License Number <br /> dW��� <br /> Contact Person (Plan Reaew) <br /> Proposed Use of Building <br /> pescription ot Work to Be Done: <br /> �'W G Ct�w-.�S I-O <br /> �( ) '1 � V S�nl.tie <br /> 0 � 3�co v �1� �I �- � <br /> FEE O <br /> NOTE: B IRN�CEWAYS MEG R ACICAB QUIRED TO �O� <br /> � <br /> dTY OF EVERETT LOCAL SALES TAX CODE,IS 3105 � �. � <br /> I hereby certily that I have read and examined fhis epplication and know Ute same to be true and ���O� ^ O�� <br /> correct. All Provisions of laws and ordinances governing Inis rype of wo�k w�11 be completed <br /> vi'oiateeorcen e�hepiovsions�o)anyothe�r9tateorlocal�d0wreguPtingpconstrucfionorthe�� <br /> perlormance of co�cat on is made snd i compry w�fhytheeStete Contractors Law 18.P27 RCW end <br /> work for which app <br /> 298 200 WAG. <br /> �..r.l�C.t a-w� `�J.al-i-«--a _7' 17' �� a- - <br /> S�gnature � <br /> Dale <br /> , . , .�5 ,� <br /> wa�o �v a�oz �ci ���r <br />