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ELECTRICAL PERMIT APPLI�ATION <br />CITY OF EVERETT PERMIT SERVICES �-9-�0 <br />32U0 C[DAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 -www.everettwa.org �/ 007—a� I <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�19 95.+�'C�, 5C t��<r<� �,J�,.9bZv� <br />I�ROJECTADDRESS C�� n S/ <br />: Yl Co r� }-� o mo <br />Ownor <br />�oi G�u�c54.un�18 A1uiys✓illo W�..4bz7� 3Ea�65q <br />hlail Addross <br />Clly � State/Zip <br />Ahone <br />�nc�,r� Non,fs_�Aoi Gro�'<S�. un; B Il�ur,•�s✓,�I. �,��. 9Az�o 360-�59-►579 <br />Tenant Mall AdA�ess Cily Stale/Zip Phono <br />Eloclrical Conlraclor Mail Address <br />�Nc a � I-I .� `l I �i �! ; <br />Slalo Liconso Numbr.r <br />Proposnd Use of Duildinr� <br />Doscription ol Work lo �o Donc: V� � r C(_Q l% i� <br />_ L?�_11,i � _ <br />� <br />NOT(=: WIRWG IN NON-DWGLLINGS IS REOUIRED TO <br />0[= RJ RACEWAYS. MC OR AC CADL[. <br />CITY OF [VERETT LOCAL SALES TAX CODE IS 3105 <br />�,1�Y <br />si,iciz�� <br />Contract Pdco ol Work <br />Conlact Porson (Plan Reviow) <br />WQ( <br />1 h�reby rnrtily fhnf 1 hm r �rud �ind rxmnined lhiv i�pplicntion nnd kno�v tho snnm to be fn�o and <br />cqr�crt. All pro��isinns ol lau�s u��i orJinnnr.�s �ovennnc� fhis ty�po o! wo�k will bo cornploted <br />uhethnr spr,alicd hcrein or nol. ilm p�anfini7 r,f n pr.nnd dnc�s nof nosumo to givo aidhonty tc <br />rielale or c�t�ncel lhv v�visions ol;�ny other sh�to rr locnl lnw rf�c�uleting construcfion or Iho <br />po�lonrumce ol cons�iucfion. TNnt I arn nidhorizeAb}� fho o�tiner of fhis property fo pedom� Ore <br />�r�nh lor �rhich applicatiurr is mado m�A I cornply ��-ifh fbe Sfnfo Conhncfors Lnw 19.27 RCW nnd <br />ZNf, 700 N'AC. <br />/,/) // / <br />V�(��i F /�i��G�. <br />-- _ ---..... <br />s,��, ������. <br />/""�1-�O <br />r'E[ <br />� <br />' .� l,Y.' -� - v_3 I <br />Phone <br />