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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.everettwa.org <br />APPLICATIONS ARF ACCEPTED FRGM 8 AM TO 4 PM <br />I�IoZ S� � J c2�—f't` 1ti.��� t.� 1�-( <br />PROJECT ADDRESS <br />Owner <br />Fdail Addmss <br />City <br />State/Zip <br />Phone <br />�-% �Z \ S�(�� 14o Z s� E UE rr T-t'r �✓14� l� l'fZ A-`/ � J':2¢-tT L.v '4 <br />Tenant Mail Address City State/Zip Phone <br />�P�IFiL S�� �1 %=2�G`t��2s �179L ���ar.�n5 e� Ry' .tl r72 Cr�r1� ,i,� �ii�- <br />Eleclrical Coniraclor Mail Address Ciry C�u�p Sta�e/Zip �P,hone <br />zr�•-w��-31�5 <br />�C-� � S� �'1 � �jC..� " I _ � �'� � / � �= <br />State License Number J Conlract Price of Work <br />c o r-...,,,. 2 r� c� rr � <br />Proposed Use af Building <br />2�� R � -� <br />Contact Person (Plan Review) <br />Description of Work to Be Done: (1�--� S� � LL � LL U�'"' � ti' '��'� � S(��' <br />�{•�SIC7"�- ��_�1�7 � <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 />y certily that 1 have read <br />All p�ovisions o/laws a <br />rspecilied herein ornot. <br />or cancel the provisions <br />is rnade <br />1 examined this applicafion and know the same fo be true and <br />ordinances ,ryoveming O�is fype of wor6 will be compleled <br />ie granfing �I a permd does nof resume fe give authonty to <br />3ny cther stafe orlocal la�v reguPfing wnstrucfion or fhe <br />1 am authorized by the o�vner of Ihis property to per�orm fhe <br />and 1 mmnlv with Ihe Sfate Confractors La�v 18.27 RCW 3nd <br />z �t� <br />Fo 7 0 �--o(�( <br />FEE <br />