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t '; <br /> y — v <br />� ,r� � -- -- — - ---- --- <br />_ .. � -- <br />� <br /> r ��.;Y-.�� <br /> � ELEGTi�ICAL PEar,�1lT ,APPL►GATIO�' <br />- ;�:+: CITY OF EVEaETT PERMIT S�FtVICES I <br /> � 32�0 CEDAR STREET, E\�ERETT, WA 98201 � <br />� T� ' 425-257-6510 - FAX 425-25'-8857 —wv�v.everetiwa.org <br />�� � <br /> ,. <br /> APPLICATIUNS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8� CREDIT CARDS ARE NQ'ACCEP'i EU <br /> F �. <br />�� ,� -- <br /> g�� . � :,i •_'. i If� ��� J - �1_ � <br />� .,3�'�` : � PROJECT ADDRESS � <br /> } F� . <br />, �.,.; — � � � I�A�ZY �'2CEIC L L C <br /> ���,,. Owner Mail Address Cii <br />� Y State/Zip nhone <br /> y�Ya <br /> ' '�J.. <br /> !,:T���a..' <br /> �_.. <br /> �s,�^{� .. I Tenant Mail Address City State/Zi � <br /> ,/ P 'r�.ane <br /> N1 F / IF111N f��LII_/Z rL.CGiRIC ylZ S 1rJNAK�, � �36� <br /> �� 2 �� F�e�aNn �,,,a � �,��� 3j�� � �-�z <br /> c tAf�yw� � Electrical Conlraclor Mail Fdtlress City Slate/Zip Phone <br />!G.st�;":; ,."� .... <br />''�.." ��IcVi��^�lt" <br /> `f�iiil/r/ ';. <br /> State License Num6er Co�lract Price of Work ' <br /> f tp:: <br /> /�� �c'(.�.t��r � ��O C 4@ Y� <br /> Proposed Use of Bmlding C�ntact Person (Plan Review) '� <br /> I � <br /> Description o(Work to Be Done: _ l� �f�n S o � I?�5,����-��� f ����tit F <br /> �'[j <br /> -;� <br /> �}s. <br /> r:: <br /> _ �. <br /> NOTE: WIkIN� IN NON-DWELLINGS IS REQUIRED TO � �'� <br /> BE IN RACEWAYS, MC OR AC CABLE. rFEE t, <br /> � , , <br /> ' ,� <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 lr'�� <br /> I hereby cerYity that I have read and examined this applicalion and know the same to be true and ' ��I <br /> conect. All provisions o/laws and ordinances govermng this type ot work will6e completed <br /> whethe�speciued herem or noL The grar,ting cl a permrt does not presume to give autnority(o <br /> violate or can,el fhe prcwsions oi any othar state orlocal law reculating construction or the �,�..; <br /> penormance ol construction. That 1 am authorized by the��•��r o(this prcperty to peAorm the <br /> work(or�vhich application is made and/comply wdh fhe Sfate Gontraciors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 1/ �. <br /> f.�/i7 <br /> ��`r�c�Gia�� /��(� �Cli� lz/���ot <br /> Signamre D te �-`� <br /> i <br /> �;ie <br /> � . <br /> �% � �� ��� � ���� <br /> _ � �� � <br /> � <br /> ',N <br />