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ELECTRICAL P�RMIT APQL.ICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR S'iREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 – www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />���a�� � `��,t= L���cQ`�� ��� ������� <br />PROJECT ADDRESS <br />Tenant <br />Eleclrical Contraclor <br />\\\\\� — <br />Mail Addmss <br />>\C1i ��i7�.a Z=,�—� <br />Mail 4ddress <br />� 1`-�r� ��` Q `1` � <br />� Mail Address <br />�tin�A��cn�%;�e <br />Sfa�e License Number <br />Proposed Use of Building <br />Description of Work to 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 />1 hereby certi/y (haf 1 have read and examined this applicafion and <br />correct. All provisrons of laws and ordinances governmg fhis fype <br />whefher specified herein or noL The ,qranting ol a peimd does not <br />violafe or cancel fhe provisions olany ofher sfate or local law regu <br />peAormance o( consirucfion. Thal 1 am aufhonzed by fhe owner o. <br />„�.k �nr whir.h anolicafion is made and 1 comp y wifh Ihe Sfafe Coi <br />�� . <br />Ciry <br />City <br />Cily <br />9-i3-ic <br />r_i�o�i-cr� <br />Slate/Zio <br />StalelZip <br />Slale/Zip <br />v� � � <br />Contrac: Price of Work <br />Nnone <br />i'� _ � <br />Phone <br />d�53 -' <br />��� � <br />Phone <br />Contacl Person (Plan Review) <br />same to be frue and <br />II be comple(ed <br />to give authonty to <br />>fruction or the <br />=rty fo peAorm the <br />aw 7A.27 RCW and <br />FEE <br />�.��%�_ � � <br />