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ELECTRICA►L PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVIGES <br />3200 CEDAR STREET, EVERETT, V'JA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br />JL`�%� � `t l'i-�r�l� 7�C(.eCL ��s.;� �a=(�- � <br />PROJECT ADDRESS <br />� <br />Owner <br />Mail Address <br />5 — �—�3 <br />�,- �3a5—E7't!� <br />�; �t��� Sz_ ��+-el��i���`'�ecu-f c,<'�Cz�¢i-ri�s <br />Ciry <br />Stata2ip <br />Phone <br />lI <br />�,�lc'_t�f- Ll�J1 ��" Z� ��� �2� 3c�� ! SZ� , <br />Tenant Mail Address City State2ip Phone <br />2NC9� -{ iZCk�ci-c'�o l ��- � �Z-S �7`17r� <br />�i:.��1,1 �1 Ci� �s �,,-� ���s�-c��r� � l;�e��rt'� ��,� �iyic..�� g53� <br />Eleclrical Conlractor <br />������� �J L3 <br />State License,flumber <br />(�1'�.�1� 11n l,-1,t l��� <br />Proposed l se of Building <br />Descriplion of Work to Be Done <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CAE3LE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily fhat I have read and examined this applicz <br />conect. All provisions o/ faws and ordinances govemm� i <br />whether spec�l�ed herein or not The qranting ol � permif <br />violate or cancel the provisions ol any other stafe or local <br />City <br />State2ip <br />��, � r1 L` <br />Contracl Price of Work <br />�G(/"G�; ��tl�.f� <br />Contact Person (Plan Review) <br />and know the same fo be true and <br />ype of work will be completed <br />not oresume to aive a�lhontv to <br />and <br />��) <br />FEE <br />5�� <br />Phone <br />�1305-0�0 <br />