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-- � , <br /> ELECTF�ICAL PE�Pr71T �,.PPLICAT'(OM <br /> CITY �F EVERETT PER�VIIT SERVICES � 2 � �Z a .�U <br /> 3200 Ci=DAR STREET, EVERETT, WA 98201 <br /> 425-257-881(1 - Fl�C 425-25'-8857 —www.everettwa.org L=0 y�Z..J 5% <br /> APPLICATIONS ARE ACCcPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> � <br /> > > - � i;��4_r fi�� <br /> PRO•IECT ADDRESS ' <br /> � :�• // �/���:f // C /" ��/�..t� /,��.r � �i'f%! r/ �c.. . �� �"`C} <br /> Owne� � Mail Address ' City State/Zip Phone <br /> i�.. - .�:(y i!r <br /> Tenant Mail Address City State/Zip phone <br /> `"' I <br /> ��I"I-t ," �•r�i ���C��/CC� I�P�L�C�r�y /�����; /7u�i� �'L �� �l �q 1� C✓�� .T_� �/� �� � �� �t. <br /> Electrical ContraClor Mail Ajtlress City State2lp Phone f <br /> � ' <br /> 5 f,-�., _ �; �'C.C: dt K/� 7 ��l _ ��';'7CJ <br /> State License Number i I G � Contract?,=�of'.Nork <br /> ,� � ; �� � � <br /> :, _ <br /> Proposed Use of 9uilding Conlact Person (Plan Raview) <br /> Description of Work to Be Dane: � � - 1� :,-� _. ..- � �,-� �s, f' r i� ��.;� <br /> / J <br /> ' Jc �i � '.� r /�i : - _ -� . .7� <br /> / <br /> / r / iC\r� :L�( i; � /.i : - i ,. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> j 1 hereby certi(y that I have read and examined this applrcation and kno�v the same to be true and <br /> correct. All provisions o/laws and ordinances goveming this rype o/v.�ork�vill be completed <br /> whether speci�ed herein or noL rhe granting of a permd does not pre sume to give aufhonty to <br /> violate or cancel fhe provisions o(any other state or/ecal law regu/atir.g construction or ihe <br /> ' pedormance of construction. That/am authonzed 6y the owner of th�s prcpeRy to pedorm the <br /> work lor which application is made and I comply with the State Contraciors Law 18.27 RCW and <br /> 296.200 WAC. <br /> i � . <br /> �- /i . : �� �� - 5 � ' � `/ <br /> Signature � ` Date ' � I <br /> , , � <br /> � Z / I� l <br /> <-� <br /> �.= � <br />