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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 ARE ACCEPTED FROM 8 AM TO 4 PM <br />2ZB SE �Je✓a� /�lA-�-`- '^��`/ <br />PROJECT ADDRESS <br />Owner <br />��000 N��� ^ <br />Tenant <br />Mali Address <br />Mail Address <br />� <br />Ciry <br />Slate2lp <br />Slate/Zip <br />Phnne <br />Phone <br />_r�l%Z��L 3�J�� Ltt�'MO�i 8L✓l) �bCE Nltl_ L �°���Jg <br />EleCtrical ContraClor Mail Address City SlalelZip Phone <br />EGOto�FF mJZA�I� �# oi (e tT <br />Slate License Number <br />Proposed Use of Building <br />Description of Work lo Be Done: <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 />I hereby certily Ihat 1 have read <br />coirect All provisions o(/aws a <br />whefher specified herein or nol. <br />violale or cancel fhe Provisions <br />�eorl� o rWh/ ch ap�/,cantrCon /s�r,i � <br />296.200 WAC. <br />Ifiis application and know t.he <br />goveminq fhis (ype o/ work w <br />8-/o-Dl� <br />Contrect Price of Work <br />�'�''t v �J <br />c � <br />Conlacl Person ( an Review) <br />�� <br />e to be true and <br />completed <br />✓e authonty to <br />tion or the <br />o perform the <br />3.27 RCW and <br />FEE <br />C�, �{� o �" - OS Z <br />