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ELEGTRICAL �ERMiT APPLICATION <br />ClTY OF EVERETT PERMIT SERVICES y_a.,5-a5 <br />3200 CEDAR STREET, EVERETT, WA 98201 � O,Grr�—�(� <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org `r`~Y <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />' � / ir�u.:(,��� � �v � <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />Mail Address <br />Mail Address <br />City <br />Cily <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />D,; J zo/� 7�' S'si ��.�;�_fr- ��,-f- ���.� 3ss-s.�yl <br />Eleclrical Contractor Mail Address City S4.ie2ip Phnne <br />(�5d � G �e- �c- oL.z c"lZ <br />Slate License Number <br />l; �S: �Ce-. ( <br />Propased Use of 13uilding <br />Description of Work lo Be Done: 1U c�« /"��1 �� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABiE. <br />CITY Of EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 he�eby ceriL� fhal 1 have read and exarnined this <br />conecl. All provisions o(laws and ordinances gov <br />whefher speci�ed herein or noL The granfin� o( a <br />vio,'ate or cancel the provisions oI an}� ofher sfafe � <br />I comply <br />kno�v the <br />o( work �v <br />_� Gi�t� <br />Contract Price of Work <br />Conlact Person (Plan Revie�N) <br />e fo be l�ue and <br />campleted <br />✓e authonty to <br />fion or fhe <br />'o peAorm the <br />'8.27 RCW and <br />FEE <br />�� O�IUy-��� <br />