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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 96201 <br />425-257-8810 - FAX 425-257-8857 - www.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Zz $' �w ev'ce crr r►��►+� wkY <br />L'1/c:2ert �. � ra. <br />PROJECTADDRESS <br />�3 (0 6� f.0 Pr't'-K e�5 V/ u. E C rr� rc2 2t�i� <br />[�FF/Gt rn►4k �,�1[-, Sh�4Ca(t FFcZGHt< QF1, �y127— <br />OWner MailAddress City State2ip Phone <br />,�t,� Gooawit,L 1400 5our�4 tlryc sT �ry►r�r'e.t a 9f�t� <br />Tenant Mail Address City State2ip Phone <br />� - - - %O 5!o Sov'fl�1^ o2o'toi+` S'r -- <br />ElectricalConVactor MallAddress <br />Sci4Ti4 F" I �7'7 �-Kl _ <br />State License Number <br />Z�-ir4i�. SA�� 5 <br />Proposed Use of Building <br />City <br />Description of Work to Be Done: !t'AJiF.�T //N I�.�Ot�tf►:�vtJT <br />NOTE: WIRING IN PION-DWELLINGS IS RCQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX COUE IS 3105 <br />I here6y ce�tiry that I neve read and examined this <br />StatelZip <br />Contract Price o� <br />K�171� (�c�t RS <br />Contact Person (Flan Review) <br />to be true and <br />ompleted <br />3 authonry to <br />!s� Z / -'D� <br />Date <br />and <br />rEE <br />Phone <br />E U�eUt� I "10 <br />