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_w � <br /> ELE�TRICA� PERMIT AF'PLI�ATlON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �2` d ���� <br /> 425-2.57-8810 - FAX 425-257-8857 —www.everettwa.org [_ 0,5�Z...Oo� <br /> APPLICATIONS r�RE ACCEPTED FROM 8 AM TO d PM <br /> —� -, i_ 7 <br /> ') � ✓ � �(: w� � u 1...�.1 <br /> PROJECT ADQRESS <br /> , <br /> 334-!?13 <br /> Ty�K��1� l��x-�<< v �� 3 <z� s G�c�w i��,,,f L` v�v��' ��A ���u�; �� <br /> Owner Mail Address City State/Zip Phone <br /> Tenanl Mail Address Ciry Slate/Zip Phone <br /> �c.tJ �t 0 N 5 <br /> Gleclrical Contraclor Mail Address City Slate2ip Phone <br /> �����,JC � �� (�� �'J <br /> State License Number Contracl Price of Work <br /> �Zi���t'� l �f �' I�C?U � V'� I�V� � C�tG�ti'� �����U S 3 _ <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> � � . . / <br /> Descrip'.ion o(Work lo Be Done: I`��' G v i N� �U �'u y '� ��,c�T l S J -✓ ( ��� ti�l�Lt��L�'?l"� <br /> �/� ti <br /> l I,�t V �LL�'�r'� l h � V� UJ �tit <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIR[D TO FEE <br /> E3E IN RACEWAYS, M:, OR AC CAB�E. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 _ � �L� <br /> 1 he�eby r,ertily fhat I have read and exanrined fhis application and know fhe same to be true and �._ � . v I <br /> conecL All provisions ol laws and o�dinances governu��this type o(work•�vill be completed <br /> whefher specil;ed herein or noL The granfing o�a pennd does not resume to give aufhonty fo <br /> violate or cancel the provisions o/any other sfate or local law reguPting construc6on or the <br /> perlor'mance ol cons6uc6on. Thaf 1 arn authorized by fhe owner ol this property to perforrn fhe <br /> work(or which applir.afion is made and 1 comply wifh the S(afe Contractors La�v 18.27 RCW and <br />� 256.200 WAC. <br /> Sic�nature Date <br /> w <br />