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;-�- � y <br /> �LECTRICAL PERMIT APPLICATION <br /> CETY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PNi -DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> -� <br /> r �-,�, fi . �,,�G��, F�,,� ;;�,� �C (>�� Qwc�� <br /> PROJECT ADDRESS <br /> � �.� <br /> L ��;-��c� �- tJ<_re�� — <br /> Owner Mall Address Ciry S�ate/Zip Phone <br /> _-�,.0 rn� <br /> Tenant MailAddress Ciry Slate2ip Phone <br /> ` s.�•: �i -:���'�'S <br /> -t ' � -�. 'vJr' y c 7 �' <br /> '�'�, �� �'�! �JlC1� `s vi__. f3310 e�`l� � '���C: ��f�i Ylc� ,..rt <br /> EleqriCal ConhadOt Mail Address City StatelZip Phone <br /> ,�, 1=: �a: 2 �:.�-�3`?1< � ���loc� �' — <br /> Stale License Number Contract Price of Work <br /> -�.� r�",`1_::�� - '��„ `. :.�,. i�C);�ys._` -r'�.'�.�:�.rc; <br /> Proposed Use of Buildin9 Conted Person (Plan Review) <br /> l � ' <br /> Description of Work to Be Done:�'� �r� ��_'�I (,U C � 2_Q �y�n y��k`{'�/pr� I (q nT' 2 �� �u.���� <br /> N <br /> � �' c'��, � r, , � }�-t„ � 2 a x ��,''D w�'f'� 3 K w Ina I <br /> � �'C i `'/� FEE <br /> NOTE: VNRING IN NON-DWELLINGS IS REDUIRED TO ;_ ( � <br /> BE IN RACEWAYS, MC OR AC CABLE. � ,, <br /> � <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br /> I hereby certily that I have read nnd examined O�is applicahon and know�he same to be true and <br /> correcL Afl provisions o/laws and ordinances governmg this type o/n�oik u•ill be completeA <br /> whefherspecified herein ornot The granting o/a pemid dces notp resuma to give authonty fo <br /> violate or cancel the provisions o/any other state or locul!aw regWating construchon or fhe <br /> peAonnance o/consln�ctron. That I am authonzed by the owner o!this property fo pedorm the <br /> work lor which applrcation is made and I�pty w�th the State Confracfors Law 1827 RCW and <br /> 296200 WAC. <br /> ,� 1�� . <br /> !' p / , / O <br /> �Y�.' , g-/- �- <br /> Signature a1e t <br /> f(' r <br /> ,II ' <br />