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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 �_a7�p� <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��-y ���Oy <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />S4 <br />Mail Address <br />Mail Address <br />Ciry <br />City <br />State2fp <br />SWle21p <br />b%0607—I �J� <br />Phone <br />Phone <br />5�9�U1^c]' fy��PGT�rLC �iOA.� S[u�?'�1 ��/`p- � P./'�i% W�. [JS%b/ y�s %�/ (00%� <br />Electrical Conlraclor Mail Address Cily Slate/Zip Phone <br />s���uEro ���iv <br />Slale License Number <br />Proposed Use of Building <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description ot Work to De Done: ���/ l^Q-ltit,OQRf � ILS �O' VD� M Oivd <br />!� `T �- Ct U�4 f7S 4-�St� �'0 Y'✓�� c% STi f2.S2 �iad tv� VY� • <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 here6y certily that I l�ave read <br />correct Allprovisionsollaws:: <br />whefher specd�ed herein or not. <br />violate or cancel lhe provisions <br />this applicafion and know the <br />aovernutq fhis lype ol woik w <br />law <br />l•� <br />FEE <br />fo be frue and <br />ompleted <br />� aufhonfv fo <br />and <br />L�v�% - � S` <br />