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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERET'T 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 />�b7 S �-. �i1�,�� /Lf ��-�C 1n/Yd-�`. ��� i , <br />PROJECT ADDRESS <br />Owner <br />l�S 6cln/ECCC . .SOd J�.t <br />Mail Address Cily <br />Mh<Lwti�. �'.�}% �ZSl3J�3-J'%�o <br />Phone <br />tj-,�.�NIN� gvti�'�T� 607 SE.L1/Z-��f Mf�CL b,/�! �vz-K2�i I�vs}9i�-�t7-z <br />Tenant MailAddress City SWlerzip Phone <br />i�u f A%F' � S CO r <br />Electrical Conlraclor <br />u rl I�. 0 <br />� <br />Maii Address <br />_Pc i �c °� 9-.r� o,� <br />Slate LicensQ Number <br />Proposed Use of Building <br />z %ukw�[�,, w�, % <br />City State/Zip <br />Description of Work to Be Done: S i Gl1�S /j�(S7i� �.�- i1 O N� <br />NOTE: WIRING IN NON-D�NELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certi(y that I have read <br />correct. All provisions of laws a <br />wheUrer specified herein or not. <br />violate or cance/ the provisions <br />perfonnancoo/constnrcfron. T <br />work for which application is me <br />296.200 WAC. <br />fhis applica(ion and know the <br />�oveming fhis type o/ work wi <br />7/2 3 <br />j�'Z,cot7 `�= <br />Contract Price of Work <br />ConlactPerson (Plan Review) <br />e to be true and <br />complefed <br />✓e authodty to <br />tion orthe <br />o perform the <br />8.27 RC W and <br />FEE <br />Phone <br />�(�0 7 - /� <br />