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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, VJA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />t, �r'``� [ L`i 5 i <br />PROJECT ADDRESS <br />2 e� �Se <br />Owner <br />Tenanl <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Mail Address <br />Mail Address <br />'J�:.. �uv„�.�/' f. l -e i_`{� <br />Electrical Conlractor Mail Address <br />�IU�iNQC�C�-a�(— <br />State License Number <br />Proposed Use of Buildin� <br />Descriplion o( Work to Be Dono: _ <br />�2 2vi� S'C� r l <br />Clty <br />City <br />3E.� .� : C� L <br />Cily <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RF�CEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />f hereby certi(y thaf 1 have read and examined this applia <br />correcL A/l provisions ollaws and ordinances govemmg <br />�rhether specified herein or noL The granting o/ a permrt <br />violafe or cancel fhe provisions o( any other state or local <br />perfom�ance o/ construction. Thaf 1 am aufhonzed by fhe <br />wo�k for �vhich app/ication is made and 1 co ly with tf+e <br />296.200 WAC. � <br />�r :s,_ � slr =1 1' (�w�L, , <br />and know fhe <br />✓pe o( work w <br />ROf plQSUlI7B <br />StatelZip <br />State/Zip <br />Slale2ip <br />�S' <br />/ �-, Oc1c� <br />Conlracl Price ot Work <br />Conlact Person (Plan Review) <br />e fo be true and <br />conlpleted <br />�e aufhonty fo <br />tion or the <br />o perlomi the <br />8.27 RCW and <br />FEE <br />Phone <br />Phone <br />Phone <br />