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ELECTF�ICAL PERMIT APF'LICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARF ACCEPTED FROM 8 AM TO 4 PM <br />��S�f �M' M: MA,�� <br />PROJECT ADDRESS <br />OwnAr <br />Tenant <br />I�� <br />Electrical <br />Mail Address <br />�.5�—�J <br />Mall Address <br />Y i � z; <br />Mail Address <br />D��f 7F � / �- , �� - <br />Slate License umber <br />Proposed Use of Building <br />Description of Work to Be Done: <br />NOTE: W IRING IN NON-DW ELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerfily that 1 have read and examrned this <br />correct All provisions o(laws and ordinances gov <br />�ahetherspeci(iedhereinornot Thearantingo(a <br />violafe or cancel the provfsions of any other state c <br />per(ormance o/construction. Thaf I am aufhonzea <br />work /or which applic�fion is rnade and 1 comply �v� <br />zss.zoo wac. i <br />� <br />City <br />Cily <br />Cily <br />iow lhe <br />work �v <br />�� � <br />Slate2ip <br />� L1 �I�e <br />Slate/Zip <br />� o0 <br />State/Zip <br />Phone <br />�} �� /�- � <br />Phone <br />� Zy��-3°6 <br />Phone <br />i,i_u <br />�QO • <br />Contract Price of Work <br />� l a�t YI� <br />Contact Person (Plan eview) <br />: to 6e true and <br />completed <br />re authonty fo <br />tion ar the <br />o perform the <br />8.27 RCW and <br />// <br />FEE <br />S 7 5� <br />ll�� -��j% <br />