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ELECTRICAL PERMIT ApPLIrATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-3810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� S �/.��'i 1��°rc-r U✓ A'`( <br />PROJECT ADDRESS <br />��-as-a <br />C- ill �����o <br />�26N�T1�Cf/11'IM�N��1�f8S �TI�Z 5F �Cit�/ (�{1n� Wl�r �tate����,✓�r l�iy/0 y�����s <br />Tenant <br />�� , <br />Electrical Conlractor <br />Mail Address <br />(�o����ob L �. <br />State License Number <br />(�T�- i �- <br />P�oposed Use of Buliding <br />Description of Work lo Be Done: <br />�A-% L 1 N t�- <br />Clty <br />Clty <br />UN � <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN R,4CEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I here6y certily that 1 have read <br />correct. All prov7sions of laws a <br />whether speclfied herein or not. <br />vlolate or cancef tlie prov(sions <br />pedortnance of construcGon. Ti <br />work for which application (s�a <br />296.200 WAC. <br />this applicafion and know lhe <br />oovemina this tvoe o( work w <br />2s� <br />Slale2ip <br />Phone <br />� , �-(�.�,�� t,✓� �l'�%� l� <br />Sfate2ip 4� QpQ�+�,() <br />`rb'! B�,I � <br />.� Z 8�do- a� <br />Contract Pnce of Work <br />V��cki� �f�h� `�3 / <br />Contact Person (Plan Review) <br />s to 6e true and <br />completed <br />�e aufhonly to <br />fion ar the <br />o peAomi the <br />8.27 RCW and <br />FEE <br />�s <br />/'I�_� �� <br />