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—� <br /> ELECTRIGAL PERMIT APPLICATION <br /> ClTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM T(J 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> ���� � �� ��, � <br /> (_'�- ,,l �'��r �� �•���, f� <br /> PROJECTADDRESS <br /> Owner h1adHddress City State/Zip Phone <br /> �:r�-�. ,i� 270� cn/6�, /�t,�- �up�r� (.il ,, � <br /> i, �!Z i F: �:�, <br /> Tenanl , MailAddress � City Slale2ip Phone <br /> ���,_t'�t JYS�rt�-� /��/f.30X <;�'i�'�.5 ✓t"(_�rr' ,[�(• 1s�/ J 7� �o°i� fi77/ <br /> ElectncalContractor MailAddress City Stale2ip Phone <br /> %/�. , ,:f5 P� PSG n<� <br /> State License Number Contrad Price of Work <br /> ���'.a �(/•''=.�n-� .l t'^�i 5)3,�. % <br /> Proposed Use of Building Conlad Person (Plan Review) <br /> Descriplion of Work to Be Oone: �`^STp �/ �O�GB�//�'f4. �:r'� ': � �� (' : !!i i,�, <br /> f�� �;Y�cJ-t�} ,O�,uc up fIT�',, <br /> NOTE: LWRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABL[. <br /> CITY OF EVERETT LOCAL SALES TAX CO�[IS 3105 <br /> 1 hereGy certily that 1 have read and examined this applicalion and know flie same to be true and <br /> conect. All provisiais ollaws and ordinances govemmg this fype o/woii���a�ill be comp/eted <br /> mlrefherspeafied herein ornoL The granLng o/a pemut does not resume to give aidhonty fo <br /> violate or cancel the provisions of any other state oNocal law m,quPting conshuction or the <br /> Wor�l�rlo avh/ch applica it o�n/s n,ade and�l co rip/yedrU th�e Sfate Corifrac(ors la�v�8 2 RCW'and <br /> 296.200 WAC. <br /> i'/l���l/� ✓-G�' C�-� `�/-,/ 1 <br /> � Signatvre Date ��I " <br /> �� <br />