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ELECTRICAL PERM� T sER cIE p►TION y�b <br />CITY OF EVERE �C� p Ib �� <br />3200 CEDAR STREET, EVERETT, WA 98291 <br />425-257-8810 - FAX 425-257-8857 — www•everettwa.org <br />"?i.' � <br />::�: / ..'� 5 ! <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />_� <br />Contracror <br />State License Number <br />Proposed Use oi Building <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />j7� �i��lri:-V !/, <br />, ,0�7 ,/ � <br />Mall Address <br />�— <br />Mail Hddress <br />Mail Address <br />Description of Work to Be Done: . <br />l ��. L c-^ 1. ..r <br />NOTE: BERN �C wAYS MC OR AC CABLEUIRED TO <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceAify fhaf 1 have read and exam(ned this applia <br />correct. All provislons o( laws and ordinances goveming <br />whether specified herein or not The 9renfin9 a� e Perm�� <br />violafe or cancel the Provisions of any other sfate or loca, <br />perfo�mance of construct7on. That I am authorized by th� <br />296 200 WAC apP��cation is made and I compty with fhe <br />/ i ^ <br />/' C_j> <br />_ ' ?� /i' ,--• - <br />Clty <br />City <br />Ciry <br />and know the seme to <br />voe o/ work will 6e, con <br />Stale/Zip <br />Slale2lp <br />plGltll4p <br />yz � <br />;a-7»l <br />Phone <br />Phone <br />DI�Mn <br />� �.-s <br />Contract Pdce of Wark <br />r;{''Ck / t � — <br />—�--- <br />Contact Person (Plan Review) <br />�ii <br />5� <br />FEE <br />and <br />to <br />and � <br />O�p-� <br />I <br />