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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRE[T, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�5' �{ c� �. � \ ��.Ja.� <br />PROJECT ADDRESS <br />Owner <br />S ��� <br />[lectricat Contraclor <br />Mail Address <br />�{U2 ' <br />Mail Address <br />Mall Address <br />S ��� ��' SoS `i � l K( <br />Slale License Number <br />Cily <br />Cily <br />City <br />Stale/Zip <br />SWIe/Zip <br />(�.kz R�Yo z <br />Slate/Zip <br />�Ob� <br />Conlract Price of N'ork <br />Proposed Use of Building Conlact Person (Plan Review) <br />Phono <br />�-1 Z S <br />Phono <br />�S3 <br />Phona <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />I hereby cerii(y that 1 have read and examined this application and <br />eorrect. All provisions o( laws and o�dinances govemmg this type <br />whetherspeci6e,i herein ornot The granfing of a permd does net <br />violate orcancel fho �rovisions of any otherstafe orlocal/a�v regu, <br />wo�k % wln'ch ennlicentior�s n,ade end�l coriip yedtl�}tlr�e Slate Coi <br />� to be frve and <br />complefed <br />o authonty to <br />fion or tho <br />o pe�fomi ihe <br />8.27 RCW ond <br />� - ( I - I 2- <br />FEE <br />5I s" <br />t1Z0�}-0�-{� <br />