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� <br /> _ <br /> �LEGTRICAL P�RIVII�' A,PPLICATIOf�� <br /> CITY OF EVERETI' PERMIT S�RVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.averettwa.org <br /> APPLiCATIONS AkE ACCFPTED FROM 8 AM TO 4 PM -DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> ��r� % y '���� � t �". _- i <br /> PRO,f ECT ADDRESS <br /> O�vnar ( '1,�_ _��`)rl- � ! l� ��rJ—�c��— ��%/t ��y /�j 1/.ZS=:<C'" - <br /> Mail Address City Stale2lp Phone <br /> �7 7 <br /> Tenanl Mail Address <br /> City Slale/Zip Phone/ <br /> ����St > > , i� . �� S <br /> 7/ai�y� ,—r>_f(',l �- 7���;L��.11���c_ �r�I�EQ�/�o��27S 4'/�-7s6G <br /> ElectricalContractor Mai;Addiess Cit - <br /> Y State�ZiP Phone <br /> �L(.l F �, " � �� <br /> -.T-�.(�-:'[�; n / <br /> State Licen,e Number <br /> Contract Price of Work <br /> Froposed Use of Buildinc� Contact Person (Plan Review) <br /> � C '1 , • . � <br /> Description of Work ta Be Gone: - �'� � <br /> �N <br /> �� <br /> /J ''�%"'"'�'d—�7 J ,� ` ' <br /> i <br /> NOTE: WI�'',ING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi/y fhaf I have read and examined this application and know the same to be true and <br /> correct. A/l Frovisions o/laws and adinances govermng this type o!work will be completed <br /> whefher spec�Ged herein or noL The granting of a permit does not presume to give authonty to <br /> viola;e or cancel the provisions of any other state or locel law regulating construction or fhe <br /> work lor which app ieatio!!s ade and l co�mp%y w lh the State Cont a�ctorsPLaLv 18.27 RC W and <br /> 296.200 WAC. <br /> � 5 <br /> �/�.,., � <br /> ���''' � ���'"CI�— � 7 � � /�( � <br /> Signaty� ✓ Cate <br /> Y�v J� � _ /� � <br />