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:� 1'_ <br /> ELEGTRICAL PERMIT APPLlCATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 58201 , <br /> 425-257-8810 - FAX425-257-8857—www.evereriwa.org a —a�-�O`� <br /> APPLICAT IONS ARE ACCEPTED FROM 8 AM TO 4 PM L"'��D Zv��/ <br /> 8 S-oC> ��� (Z�r�� <br /> PROJECT ADDRESS � 3� aSGi. <br /> � �r�„c�.S ��+1`-/d- �� �� /�+.� �.4 v�4 <br /> ��Y State2ip Phone <br /> OWner Mail Addreu <br /> t'�,�S1G— — /,(1nE21 'SSoc� E�1ZG(2�F� ll..�l � <br /> City late2ip Phone <br /> Tenanl Mail Address �� <br /> Cn- L,�e.s N� �a2 �� ��` �" S� �.6A �-� �4� <br /> ��Y StaklZfp Phone <br /> Electrical Co ;ladof Mail Address <br /> �.J �'?s�c�� <br /> G�' �-- � � � �� Contract Price ot work <br /> State Licen e Nu ber ���_ � <br /> �ti^r�n�-�� � � / "— " -- o�n a t Person (P�I L�ywew��— <br /> Proposed Use of Bwlding o y��-'� <br /> ^ ' C •� �l <br /> Description oi Work to Be Done: <br /> �� /�"`""�'� � <br /> �-� 1�j �rc- • r> -T`a ��G� l <br /> y � /� /� <br /> �� / /I A C i� 1 G�CJ��/�� <br /> �'� L� \ C J <br /> I FEE� <br /> NOTE: BERN RACEWAYS MC OR AC CAB EUIRED TO � o G <br /> CITY OF EVEREIT LOCAL SALES TAX COD�IS 3105 <br /> 1 hereby certily fhat 1 have read end examined this applicafion and know the same fo be frue and � � <br /> corroct. All provisions o(laws and ordinances goveming this type ol work will be,completed 1 � <br /> whether speafied herem or noL The granting o/a permR does not presume to grve aufhonty lo I <br /> violafe or cancel the provisions o/any Wher state or local lew�egulahng consWcfion or f..e J�� <br /> peAormance of construction. That I am aufhonzed 6y fhe owner o(this propeRy fo peAorm the i <br /> 296(� yAc�h applicafion is meda and 1 comply wrth the Sfate Contractors Law iH27 RCW and D� <br /> ,��.; —'�.���zs� �1 �1�a � ��'I,'� <br /> SlgnaWre Date , I �/, <br /> r �� <br />