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-�'.�-7�7 Z�',`Z- : ,, <br /> ELECTRICAL PE�RMIT APPLICATION <br /> CITY OF, EVERETT PERMIT��ERVI.CES 4 <br /> - 3200 GEDAR STREET; EVERETT, WA 98201; ; <br /> " 425-257=88'10 - FAX 425 257-8857=www.everettwa.org .: <br /> APPLICATIONS ARE ACCEPTED FR"OM 8 AM TO 4 PM � <br /> : 2I � � � C���` s-� . S� ` ��� . <br /> PROJECT ADDRESS : <br /> �.` . :: <br /> eQ ; ��5�+:► � ��` 44t5�.�������s� . - . :���� SN1� �. � 12 �iz� -�� ,.., <br /> , OWner Mail Address City ` State/Zip Phone <br /> �rz`r � ,�Z�-c_. �c�� �c��cN : ��L� : ,�� :;°����4 4�7�� � : <br /> '"Tenant Mail.Address City •, -State/Zip Phone <br /> ElectriCal Contractor' Mail Address City '_State/Zip Phone <br /> `���✓ <br /> State License:Number Gontract Price of Work- <br /> ��r��-�.� �i�.-r � ��c���� <br /> Proposed Use of Building : ' , Contact'Person;(Plan Review) <br /> Description of'Workto Be Done: �-�� ���7 � � � ��� `��'�� (,,.� <br /> NOTE: WIRIN.G IN:NON-DV1/ECLINGS IS REQUIREQ TO FEE - <br /> BE IN RAGEWAYS,�.MC OR AC;CABLE. <br /> , . <br /> CITY:OF EVERETT'LOCAL SALES TAX CODE IS 3105 `' <br /> 1 hereby certify that!have r.ead and examined this application and know the s,ame to be true'and ��/-t'� ! " �"i� <br /> correcx All p�rovisions of laws and ordinances governin�th�i's type of work�w�ll b�.completed, , " <br /> wl�ether specifi�d her.ein or`not. The granting.of a.perm�t does not resume fo give authonty to <br /> violate or cancel the prov�sions of any otlier:stafe or:/ocal law regu�ting construction or'the <br /> perforinance•of cons#ruct�on. That l�am authorized ky 1Fie owner of this property to perform fhe <br /> work for.whicli application is made:and I co►nply with the State Contractors Law 18:27 RCW and <br /> 296:200 WAG: , . ` <br /> e�t, �.CP o <br /> �i nature : � afe: _ ; <br /> f/�2�, Cp � . <br /> � � <br />