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ELECi'R�CAL PERMIT APPLICATION <br />CITY OF EVERETT P�RMIT SERVICES �_�� �b� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wwvr.everettwa.org G� 66 y_d 77 <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />. � _:.�.�� � �� <br />Eleclrical Contraclor <br />Slate License Number <br />Proposed Use of Building <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />i� <br />Mail Address <br />Mail Address <br />Mail Address <br />� _ <br />City <br />Cily <br />City <br />_ �� ," "_ � <br />Sla�e/Zip Phone <br />State/Zip <br />Slate/Zip <br />Contracl Price of Work <br />Contact Person (Plan Review) <br />Phone <br />Phone <br />i . _1 � <br />Description of Work ta Be �one: ,'�� -i ✓� �=' � �..I �: ; i". i �- =- i ; - ��� ! �� i �'� � , ;- "j — <br />i i, _ ..� ,/'-�� n_ <br />'1. I� .<' /�'�/���>:'J. / � •�. _ " ,% <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERElT LOCAL SALES TAX CODE IS 3105 <br />I hereby certi/y that I have read and examined fhis applic <br />correct. All provisions o/laws and ordinances c�overnrng <br />whether specibed herein or not The c�ranfing o/ a permd <br />violafe or cancel the provisions oI any ofher state or locai <br />performance o! construction. That 1 arn aulhorized by the <br />work /or which app/ication is made and I comply with the <br />296.200 WAC. . <br />3tion and know the same to 6e true and <br />tl�is type ol work will be campleted <br />dc^s nof presume fo �ive authonty (o <br />law repi atinp construc6on or the <br />i' , , ' ' _ , ' ,_ ' , <br />SipnaWre Dalo �� <br />and <br />FEE <br />