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ELECTRICAL P�RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everelt�va.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��1 ,� c���r-:rf m���- �v � rn5 <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />A7ail Address <br />A7ail Address <br />F?,1:3�TS�Lti' �12VI� !�-�Iz <br />Electrical Contractor Maii Address <br />13P�'f�S1S� ��ni� <br />Sta�e License Number <br />�Lr�'1n�C�Az� /,SI�N <br />Proposed Use of Building <br />Description of Work lo �e Done: <br />NOTE: W!RING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CADLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cerii(y thaf 1 have iead and <br />correct. All provisions olla�vs and o <br />�ti�hefhersnec�fiedherernornoL Th� <br />is <br />Cily <br />w <br />c�y <br />Ci�y <br />Ihis applicafion and know fhe <br />ga�erning this type ol �vork w <br />�/a pennd does nol presume <br />3fe or local law re�ulafing con <br />ized by the o�vner ol this prop <br />'y �vi(h the Sfate Contracfors l <br />�//P�/`� <br />state/zin <br />Stale/Zip <br />SlatelZip <br />d �z5. �.� <br />Conlrecl Price of Work <br />Phone <br />I�� <br />Phone <br />53�z,.�/�, <br />Phone <br />��� � � �� <br />Contacl Person (Plan Review) <br />e fo 6e frue and <br />comp/efed <br />ve aufhonty to <br />fion arthe <br />'o pedorm the <br />'8.27 RCIv and <br />FEE <br />`JV� <br />L-.I"to� � O�`'f <br />1 <br />