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Ju�. 25. 2Ui0 9: 14AM Protection One No. 2995 P. 2 <br /> � � ` <br /> ELECTRICAL PERlVIIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET7, WA 98201 � a S—!O <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org � <br /> E'iao6�� 3 � <br /> APPIICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 15oU� .:�.�a�e� Q�.�e, <br /> PROJECT ADDRESS <br /> (_ ' ?� ?�-���' 4� <br /> OWnOf ` MaitAddress � Clty SIatNZlp �lb� p^one <br /> ��� ���.�lvi I �.�lC) I"�1�.e�t f` , rl ��D �}" �1 /�1 oc ���� <br /> 7enant Mail Addmas c� <br /> Slale2iD 9��' . Phone <br /> I�rnl�r ����P� �,�7 S , l�t�'��� u �-lqg�.� �d'>�`�� _ <br /> •EleclricalContreclor M�IlAddress Clty S�a�e21D `�(��� Phona <br /> _�I�Il���S���� <br /> Stale License Numbe Contract Pdce o(Work�f� (prj(`���� <br /> � <br /> 5m�ke ��x� ( ' <br /> Proposed Usa of Buildin8 Contact Person ( an Revlew) <br /> Description of W�.�1c to Be Done: �JL1�/ �� �1/�[��� ��,�/1 <br /> NOT�: �VIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> '�E IN RqCEWAYS, MC OR AC CABLE. <br /> CI7Y OF 1iVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here6y cer;ily lhaf 1 have read and examinad fhis eppllcafion and know fhe same fo 6a true and � ' vV�_ � � D <br /> conect. All proVisions of lews and ordlnsncos governing fhis fy,�e o(�vork wil!be complated <br /> whelher spec�!ied hereln or nof. Tlie grantinp ol a pertnrt does nof prosame to g!✓e aufhority fo <br /> vlolafa or cance!tne pNvisions ol any ofhor stafe or loca!law regulafing conshucfion or fbe <br /> pa�formancr ol conslrucfioa Thef!am autAo6zed by ihe o�rnor of fhls property to pedorm fho <br /> n�ork lur whlch epplicafion Is made and I compty tvith fhe Sfaie Confracfors Law 18.27 RCW and <br /> 296.200 WAC. . <br /> ' , "_ �(►Q.�IY (� �� � <br /> Sipnaluro Dale <br />