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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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � b�0� �1 �"� `��� <br /> PROJECT ADDRESS <br /> ��-�. <br /> �y//�� p �' / � � �1�.3-t'� L�� ��L`,� 3�Fy-IyBY <br /> � I������ "�' I� U�R�/'�� � L�'�0 � �/'�- - <br /> Owner Mail Address <br /> City SlalelZip Phone <br /> Tenant l (� Mail Atldress Cily State2ip �h� <br /> � <br /> � ���-' rJ� i(o�`�t .����uc� �Jn c�Bb�S ��z- <br /> ��ll'1Z�Pl-. ��E'C{'l.i�.�3J�C� Ll�= ���� <br /> Electrical Contrector Mail Address <br /> City State2ip Phone <br /> �3:�v� , <br /> L F� ���t"L S �`� � ��C Contracl Price of Work <br /> Slate License Number <br /> ��QG��4'�,1� _ ��.�l�.�l�'�'�i <br /> �/�'� — J <br /> Conlact Person (Plan Review) <br /> Proposed�—���9 <br /> � ) i <br /> Descriplion of Work to Be Done: <br /> I�1,�. �CG'v � I�YI � ��CLf�S.-- <br /> FEE <br /> NOTE: BERN RACEWAY9 MCLOR AC CAB�E.IRED TO ��/ �� <br /> CITY OF EV�RETT LOCAL SALES TAX CODE IS 3105 <br /> co�rrocfy All provisions o/la 9s and o dinancos govenil n�gl hl s type op(�ork�vill be comp efed and <br /> v{iolate or Pan el Uho prov sions ol eny ofhe�r�9tat aor local la�v ragulahng construcfion or�fhey t� <br /> peAormanco o(construcfwn. That 1 am authonzod.by(ho ownor of this property to pedonn the <br /> 296.200 WAC.a�p��cafion is made and I compty wdh thQ Stafe Confractors Law 18.27 RCW and <br /> .� ('��-; <br /> , , � �{ (J G <br /> �1 ' ` �'�(.�.il� � 'r u <br /> .-�" �_ �-�C- Dale <br /> Signalure ` � ry�0-_r,'� ' <br /> � O �cx <br />