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---- <br /> ( <br /> ELECTRICAL PERM�iT sER i��ESp`TION <br /> CITY OF EVERETT <br /> 3200 CEDAR STREFT, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —ww`n'•everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> ��s�� Nw �� s���c, <br /> PROJECT ADDRESS �U��C��w� <br /> I �. �U�r�- G.�f� �(�'3�7 sz <br /> 4..1(„) 1� �� ����� Slate2ip Phone <br /> Mail Address ���Y (� <br /> Owne �'J,Lr �ec`� w` �V-�,� `,-�� l��'� �7�7G� <br /> ,(� f <br /> V/�'Fv f IMyH(� 5�•� ' Phone <br /> City StatelZip '�C:U-- <br /> Tenant Mail Address /��-(3 25 <br /> �/ /\ ',,�r-�_ o� Kw� q� 5: iM����-��,�.� w�+ ����3 �l <br /> ��t�� �l'� �\? �`1� � � Stare2iP Phone <br /> Mail Address City <br /> Electrical Cuntractor ' ��� <br /> �uC�� ���(��� — Contrac(Pe of Work <br /> State License Number i(1� I.� L u,,�� � <br /> /',- r �/� ,�—J'— . <br /> C "�1 �U 1 . — Contacl?ersor. (Plan Review) <br /> Proposed Use of Building <br /> 4�I,1 ( oI� S(' L <br /> Description af Work to Be Dcne: �S <br /> FEE <br /> NOTE: BERN RAC WAYSWMC ORGACICABLEUIRED TO <br /> CITY OF EVERETT LOCAL SALES T!il(CODE IS 3105 <br /> co7eecby A��p ovhsions ollaws and ordinance�govemPng thlsnrype opf work will 6e compe f d and <br /> le <br /> violete orPancel�he�ro✓sions o(any othar 9tafe P local�OeS�7 t/ahng conshuchcn ohthey t� n <br /> peAormance of construction. Thaf 1 am authonzed by thP owner of fhis property�o perlorm the /, <br /> work for which applica6on�s maciz and 1 comply with !:ie State Contractors Law .8.27 RCW and / <br /> 296.200 WAC. `��`� <br /> �/, � �� � �' �� / . <br /> "� ` �ate l� <br /> S� ignaWre <br />