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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� � � <br />� %���, �l �� C�I'f-%'C ( ��/% <br />PROJECT ADDkESS <br />4<<� <br />"%1/i i-/ � �' l S<��� �{� � � ar �� �/ �l ��%t=�ltiT (� %��� �i' x�7/� %c�c;.��� <br />Ownor Mail Addross Clly Slale/Zip Phono <br />Tenant <br />M11ail Address <br />City <br />Stale/Zip <br />Phono <br />%�� �7 �'/��%�� �i L�i.,� ,-��i/ I"�i-i�� lC�<( r%��i� �/zs;c��i�i <br />ElecUical Conlractor �fail Address Ciry State2ip Phone <br />`� �.i. � � �-� <br />Slate License Number <br />Proposed Uso of Buildiny <br />Doscriplion of Work lo �n Donc: <br />NOTE: WIRING IN NON-DW[LLINGS IS REDUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE 13 3105 <br />I heieby certily that 1 have read and ez�arnined O�is <br />conect. All provisions olla�vs r�nd or�linances gov <br />�shether specilied herein ornot iho 9ranfinr� ola <br />violafe o� cancel tlie provisions ol any oflier sfafo c <br />perlo�nwnce oI consfmr,tion. Thnt 1 ant authorized <br />�vo�k !oi �shich applicafion is made mid I comply �vi <br />29G.7.00 lNA C. <br />�v <br />hnow Iho <br />01 work w <br />Conlracl Price of Work <br />Conlacl Person (Plan Revie�v) <br />3 to bo We and <br />compleled <br />�e aufhonty fo <br />fion or fl�e <br />o perfom; fho <br />8.27 RCW and <br />� . „ _ , . i�, <br />�.� c. �" � � <br />Sign�:ure Dato <br />FEE <br />��/ <br />/��l . <br />