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Thursday 28 of Jul 2011, lckinstry <br />->425 7 8$57 Page 2 of 2 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREE7, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROUI 8 AM TO 4 PM <br />A. <br />/���Se � �ii.��9���irV'�4 y <br />PROJECT ADDRESS <br />Owner <br />Tonont <br />Addross <br />Mail Addross <br />,C� <br />Electrical Contractor � Mall Address <br />/�I �� ,�rv G` Q�aa,v . <br />Stalc License humber <br />N <br />Propos d Use of Buitding <br />DescripUon of Work ro De Done: � <br />//� /J��ela s�cz-f� -- <br />NOTE: WIRING IN NON-DWELLINGS IS R[QUIRED YO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF 6VERETT LOCAL SALES TAX CODE IS 3105 <br />CIry <br />CIt� <br />StatelZlp <br />��LR�' � <br />Slalo/Zip <br />�4•9 - �'a- <br />c�z�, o�)co <br />.�,�o l',a�a�,�.. <br />Phone <br />�%r3tj—c�i�b^%S(o.i <br />Pliono <br />s�g�a �� y,��3�� c�Ub'7(o.�-33!( <br />Ciry � Slale2lp � Phone <br />� l�loD.��o <br />Contract Price o( Work <br />�-�%di �/�� ,�Jz�;T aM^, <br />Gontect Pcrson (Plan Rr�low) <br />n <br />FEE <br />`'� �C� <br />//b-� - � �7 <br />