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�LECTKICAL PERMIT APPLICATION <br /> C17Y OF EVERETT PERMIT SERVICES <br /> r 3200 CEDAR STREET, EVERETT, WA 98201 � `�b_p� <br /> 42�-257-8810 - FAX 425-257-8857 -www.everettwa.org C �go �`v� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ! �IUv I��'cI'c ";� /{ �! �' <br /> PROJECT ADDRESS <br /> � .�/1 Il t' ��,; {� ,� � ,, %'�S %2�-3�7�� <br /> O�vner � A1ailAddress Cily S1a>'Zlp Phone <br /> Ten2nt Mail Address City State/Zip Phone <br /> 1�'��� lA�[1����1C7�i�ri ��i)1 17L.`�' J[�ir /l�l,_/,-•„ 6v� 9E.:�� ��>5=�y"F ;'�� � <br /> [lecitical ConiracloYJ Mail Address � Ciry 'J State2ip Phone <br /> 1� � ��G�� ��'< �'l3) C C �� �.'U - <br /> State License Number Coniract Price ol Vdork <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work lo Bo Done: � � � �%Ll�, c �-�;-ri,�,. c .�i� ��i l,'� l c' /V c=�L' <br /> NOTE: WIRIIVG IN NON-DW[LLINGS IS REQUIRLD TO FEE <br /> B[ IN RACEWAYS, t�4C OR AC r,qpLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerfily fhaf I have read and examined fhis applir,alion and kno�r fhe same to be tr,ie and <br /> con�ecL All provisions o/la�rs and ordinonces�overnmg this type o/work will be completed <br /> whefher spea!ied he�ein or nof. The granling oI a permd does nof resurne fo gi��e aufhorify lo <br /> viofafe er cance/the provisions of any ofher stafe or/ocal la�r reguPfing consWr.hon or fhe <br /> peAomtance olconslrucfion. Thaf 1 am authorized by the owner o!this propeAy fo pe�lorm the <br /> �vork lor�ahidi opplication is made and I cemplp with fhe State Confracfors Lau� f8.27 RCW and <br /> 296.200 WAC. � <br /> � � � <br /> i .' �' i _ <br /> �f'� � �� /��.� � � � ; ' , � — <br /> L ' <br /> si�jnawre - ate � <br /> �1.'��1; � -�� ) 5 <br />