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ELEC�'RICAL PERMIT APPLIGAT[ON <br />CITY OF EVEREYi' PERMIT �ERVI�ES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettw�.org <br />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />�� ���� �✓�� � <br />PROJECT ADDRESS <br />S -3 -�� <br />�; p 7O,5—D�J <br />< <br />.�I,�,� /!���=���� t,3��i )� ���� <br />OwnCf Mail AHHress Cily <br />.��Y��� _ <br />Tenant Mail Address � � Q�y <br />CC�r� �� c i�c�<w ��D� ��u S�i� C=_�- <br />Eleclrical Conlreclor tdail Address Ciry <br />������c� � �i3�o�J <br />Slate �icense Number <br />I <br />�` `-<`- <br />Proposed Use af Building <br />Descriplion of Work lo De Done: C%r.i� j�r�'� ��� f-: <br />NOTE: WIRING IN NOtJ-DWELIINGS IS REQUIRED TO <br />8E IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Phone <br />Slate/Zip Phone <br />��' L�%/-�/�'.�' <br />(,J�- �'zSZ <br />State2ip <br />/,,�?oc� <br />ConL act Price of W ork <br />Contact Person (Plan Revir,w) <br />y certily thaf 1 have ;ead and examined this npplication and knew fhe same to 6e true and <br />. All provisions oRaws and ordinances yovernmg fhis p�pe ol wor�< will be completed <br />r speciGed herein or noL The granting o/a perrnit does nef presuvie to give aufltonty fo <br />o� cance/ the provisions o/any other sfate or leca! law regulating r.onsfruchon or the <br />iance o(consfrucfion. That I am authorized by fhe owner e( this propert}� to pa�form the <br />r which application is rnade and I comply wifh fhe Stafe Coniracrors Law f827 RCW and <br />� _ ��. �' �" r��;14Z i �. ��. <br />`3 - o <br />FEE <br />�c�c5-cz5 <br />Phone <br />