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� <br /> ---- --� <br /> �LECTRICAL PFRMIT APPLICATION <br /> CITY OF EVERETT PERPdIT SEt�VICES <br /> 3200 CEDAR STREET, EVERFTT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8F357-www.everettwa.org <br /> ��� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DE81T$ CREDIT CARDS ARE NOT ACCEpTED I <br /> J <br /> i <br /> !', � � � � �� �.ly�---_- <br /> PFtOJECT ADDRESS <br /> � ������ <br /> ��t�1���,�11�� � -�'��:��-����1 ,�t'�; . <br /> O��vner hA2.l Address City State/Zip Phone <br /> Tfnanl PAailAddress City Slate/Zip Phone <br /> '��-�� �1, r, �� � �' ���E�^ �.o���,�1 I �i`�F-�- K� <br /> [b.clrical Contractor Mail Address Cily State2ip Phone <br /> � <br /> ��^_�'Cr'�Y l� ���� <br /> State License Number Conlract P�:ce of Work <br /> v•��.�$.����— ' <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> ` � . <br /> Des!:ription of Work to Be Done��` .C��"2�`l . �]'���(„y'�,��'^� \ <br /> _ �_ <br /> , <br /> NOTE: WIRIIJG IN NON-DWEL�IflGS IS�EQ�IRED TO FEc <br /> BE IN F'.ACE�VAYS, MC OR.4C CAFILE. <br /> ,i <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � I hereby certilV that 1 have read and�xamined!his appfication a id kn��r tbe same fo ue true and <br /> r,orrecL All piovision;o/laws a��Aordirances goverm:ig th�s rype ol�+�orA�t;!;bc�orr�leted <br /> whether speci6ed herein or neL The�ranting ol pernut does not�resurnP!o gve aduority to <br /> I vio�nteorcancelthe provisionsota�iyolherstaSr�orlocallawregW2tin,qconsiructun �i he <br /> perlormance ol ronstructien. Tl;at!am ay;therfed by the owner o�"vs property to pedc��m the <br /> work lor wh�ch applicairon is made and l,con�/)�y with the Stafe Cor,;.�ctors Law fA.27 F?�'�W and <br /> 296.200 Ws1C. j� % ��/ <br /> j' , � � 1 <br /> �� I i r <br /> I _`�� ,y/ yI' �- r �4-1'J\�� - - <br /> ignature Dale <br /> i / t—`%L c;5 - I 7 � <br /> I <br /> - ��`'". <br />