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�LECTf�{CAL PER�VIIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 �_ 0 I�-�� <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org ��Z <br />EG ��7 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />i yO-� S�� L_ �� ���-�r �1�� ,%/ �,�: y <br />PROJECT ADDRESS <br />Owner ldail Addmss City <br />t� e. / <br />Tenant <br />�,� /r�� <br />�wi 5 7`� � <br />Mail Audress <br />�/�Ufr�c / �, � <br />Eleclrical Conlraclor Mail Address <br />i � ,� � <br />/�� �' U l �. �� s �i � � � J C� <br />Slate License Number <br />Proposed Us� fo Building <br />/�/� <br />Descriplion o( Work lo Be Done: /'� � � <br />City <br />S�al�rZip <br />�iL.LTd <br />Stale/Zip Phone <br />( Z �S� "_-; -�f���Z�G <br />5�?b.Zip PhonB <br />� - Ze�`i3�<1�" <br />- .%��"i ��0�� <br />� Contrecl Price of Worh <br />1 <br />Cc�lact Person (Plan Review) �— <br />��,.t�� �i�/�7�ih� <br />PJOTE WIRIN�; IN NON-DWELLWGS IS REQUIRED TO FEE <br />BE IN F'ACEVVAYS, tv1C OR AC C:�BLE. <br />CITY OF EVEREI"f LOCAL SALES TAX CODE IS 3105 <br />I hereby certify thaf 1 have read and exarnined Ihis appli�ation r�nd know fhe samc to be true and <br />correcL All provisions olla�vs and ordinances govern� ;� this fype ol work wii' tia comp/eted <br />whether speciGed herein or not. The �ranting o/ a per,nd does nof prnsume i: � jirp authonty fo <br />violate or cancel the provisions ol any ofher sfa(s or local lou� regulating coc;t: ar;:>,;:,, a�:he <br />pe�fonnance of construction. Thaf I am autFonzed b}� tho oaner o/ this p;o;�en+, r,� t�r'carv� the <br />work !or wh:;h applicafion is made and 1 compiy �vilh Ihe State Contractors Lnia �,4 <?,�r: it .��d <br />296.200 WAC. <br />_ —, �---_ <br />C% %G / :✓� <br />�� <br />, - .-- <br />,; . <br />