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K <br />ELECTFtICAL PERMIT' APPLICATION <br />CIiY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br />APPLICATIQNS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />CI l b 5E �i�Pive� ✓)'1 dat� 1,,��4.i,/ #G- <br />�- <br />PROJECT ADDRESS <br />�VmCf <br />Mail Addres, <br />S/ o <br />c ryo2Tthi P[.J i4 y'�/zv kl ✓��4 n� �.,, r�- <br />��, StatelZip Phone <br />I I D �c J S �_f J Sc E✓l ir�( I%1% /�LC- W0.., # G is ✓2✓ PA C�7i- Y r LO d <br />Tenant <br />MailAddmss Cdy Stat��Zip Phono <br />�x yu-zr.r-i sfi <br />--r doa „a-i,e�.Gl Ssr..� Iz�l��-1 rl�r �i4�2.�Eve�-atl c��4 9d�y y�_ws-is�7 <br />ElectriwlContractar MailAadress �M <br />Stale2ip Phono <br />r�-r�s� ��� �t � <br />State License Number <br />� .Mt�,✓Gt �� , <br />Proposed Use of Buildiny <br />Description of Workto Be Dane: <br />NOTE. WIRING IN NON-DWELLINGS IS REC]UIRED TO <br />RE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />00 <br />(ODD— <br />Contrad Price of VN�rk <br />'0_�. � <br />.WS�-��n� �.> <br />Contact Porson (Plan Review) <br />�Qv�vl.?�t �Cl�" <br />FEE <br />I hereby certily thal I heve read and ezemined this applicetion end kno�v fhe seme to 6e tnie end <br />correct. All provisians ollews and ordinences govemmg th�s type aI work wll be completed <br />whether speci(ed herein or noL The granfing ol a pemvt docs nof prewme fo givo eufhonty fo <br />violate or cancel the pmvisions ol eny othei sfe(e or local lew mgulating� Pstmcfio� t fhe <br />peAormance ol construdion. Thet 1 em euthonzod 6y fho owner o/fhis o e to r(orm fhe <br />wodc far which epplicofion is made end 1 comply with fhe Stete Conhacfors Lew 1B.27 RC W end <br />?96200 WAC. <br />�.=L2�� �-�l-os <br />.EG5�7 •C�S <br />