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12�01/2qi38 n?: 13 4254N852HH FAGE i)1/02 <br /> ELECTRICAL PERMIT APPLICATION <br /> CiTY OF EVERETT PERMIT SERVICES <br /> 3200 CFDAR S7REET, EVERETT, WA 98201 <br /> 425-257-E810 - FAX425-25i-OS57-wv.+w.everettwa.org �� —��"� <br /> AoPLICA710N5 ARE ACCEPT[D FROM£3 AM TO 4 PM C O�I Z�w� <br /> ¢�j��OJ EUr.tP�P W <br /> PROJECT ADDR[SS <br /> Uwner t.7n��1 Fddresc <br /> C��y Statc2lp Pnano <br /> qZr <br /> P,�..1v- OP .A-n.�-P-�� q- £�'t�D Ev�zG2G-s+J c�u�,�J- �ss'-1!?�- <br /> S�atelLlp Pnona <br /> 7enant t.tail Facress �'h' 2 y3 <br /> 3'�?--1 f fe� <br /> fl�� �x-U-ii��n; Sm� c.c� ll�2 / r% CPcsr�prw/ d �IbT O:i7fcu k.�h y�G�l/ Phonc <br /> Elednral Contrector t.lall Addrecs City Statc2lp <br /> � SDd.°� <br /> f}�7��cyyij�'ZJS ContractPriceofWork <br /> State License Number <br /> Jzrn i3�ti 253-3�}'���i��i <br /> PropOsed lJse of Building <br /> Ccntact Person (Plan P,eviev+) <br /> Description of Work to Ba Done: <br /> �� ,,r �.cr2, s si2-+c�.. ( Z 9ev�c�'i� <br /> NOTE: BERN RACEWAYS�CLOR AC CABq[IRED TO <br /> FEE <br /> CITY OF EVERET7 LOCAL SALES TAX cODE IS 3�05 <br /> �� I nemby certify fhat i hove read dnd oxamined this app�ic�tion cnd knew ths ssme fo be we and <br /> ! c;,rmct All provisions of/aws and ordinar,cr+s gowming fnis type o!�vork�vin bo eomplefaa <br /> I �:�nefherspocilied horr+in ornof. The granting cla permff daos not p�sume fo give nufhonty ta <br /> �.doiafo orcancol fhe provisions oI any othersf�te eNecnl law mgulafing cen:truction cr fho <br /> ;:r.-dormance of construchon. 7ftef I am euthcnzed by the ownor of thls propery to per'onn the <br /> ! �.•:ork for�vhiah appllcahon Is made entl��mply wilh;ho Sfate Centr�clors La�v iB.2�RCW and <br /> � <br /> tt96.200 WAQ � <br /> I � _ /2 '/ - °a' <br /> � oare <br /> � �gnaturc <br /> � E�81'Z-00�-- <br />