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CtE�TRICAL PERMIT APPLIC�►TION <br /> CITY OF EVERE7T PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 42.5-257-8857 —www•everettwa.org <br /> APPLICATIONS ARE ACCEPTED rROM 8 A�A TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> 1505 l-o���ba�d �+le, �vLr�( �18'ZD I <br /> PROJECT ADDRESS <br /> �r�r���'fonks i�o5 �on�iba�l Ave Fver�tl w� a��� yzS`�y3��33� <br /> q � �� Phone <br /> Owner Mail Address �"Y <br /> � �a� Ciry StalelZip Phono <br /> Tenant Mail Address <br /> V�-�'�- �OW6L('lr "t0 C�b u31Yi��0. I StatclZip Phone <br /> Electrical Conlractor hta�l Adn�ess �'�1' <br /> Contract Price o(Work <br /> State License Number <br /> .. ,�.�, ^esi��.v��'�- j4����,te {=�� ��t �l�, i <br /> ���a,�,�.�T,�� es <br /> Contact Person (Plan Review? <br /> Proposed Use of Building ° � <br /> Description ot Work to Be Done: � WIVI�1q �kU�b{ �b�) � �'f ����a�' �� ��� ��O�hl <br /> t4t4 Ico.�-kY �I/�}WitU. 1KoYwP x . <br /> NOTE: BERN�C WAYBWMC OR AC CAB�UIRED TO <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceRi(y that 1 have read and examined fhis application and know the same to be Irue and <br /> correct. All provisions o//aws and ordinances governing this type o/work will ba completed <br /> whether speci6ed herem or noL The granfing oI a permd does not resume to�7ive authonry fo <br /> violate or cancel the provisions o(any olher state or locallaw reguPting constniction or the <br /> per/ormance o/construction. Thaf I am authorized by the owner olthis propeRy lo per�orm the <br /> work(or which applicafion is made and 1 comp/y with the Sfate Contracfors Law 7827 RCW and <br /> 296.200 WAC. <br /> � j % Yi <br /> < � � ;,c�� � 1- �,,� ;� i 1 i� l �, <br /> ,5ignaWre r � ; Date <br /> _ F o50�-0(�8 <br />