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i_,us, xoio is:ai r•.�.� azs ��� i��c uit� ia.r:c•risic <br />C�i o u t <br />ELECTRICAL PERMIIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />�a`i�-(d <br />APPLICA710NS ARE ACCEPTED FROM 8 AM TO 4 PM c a� O�U <br />L_ �0� <br />as3� f-lar+ a�F �..� t� <br />PROJECT AUDRESS <br />O.vner <br />Tenant <br />Eloctncai Conlredor <br />j�, E�5 �I�,� � <br />State Liconse Number <br />( �n v (�G� <br />Proposed Use of Building <br />Descdption of Woifc to Bc Done: <br />Mail �atlress <br />Mail AAdress <br />lZ <br />A1ei1 Addmss <br />Ctty <br />Ciiy <br />sie��z�� <br />Stata/Zip <br />Slele2ip <br />��q NoYd� <br />� ,, �z5-3�i-�s z <br />Phona <br />Pho� <br />, yz5-4u-17Y�( <br />Phone <br />����`� �b <br />Contrad Price of Work <br />t�iobS.-i �L•Ps� <br />Contact Person (Plan Review) <br />CL✓1 � �- "� i y � � <br />NOTE: WIRING Ri NON-DWELLINGS IS REQUIRED TO <br />OE IN RACEWAYS, �dC OR AC CABLE. <br />CIIY OF FVERETT LOCAL SALES TAX CODE IS 3106 <br />I horo6y certi/y the�f I have �eed end examinod fhis upplieation and know tho same fo bo frue and <br />corrucf. All pmvisions oNaws and ortiinances povoming (hrs f��e o! worlc wdl be cnmplefed <br />whelhorspecised heroin or not. Tfre gran(ing o/a p�rmrt doos nof prosumo to yivo nu(hanty fo <br />vio/a!e or cancol fhe p�ovisicns olsny ofher slofo oNOcal l.1w iepu/ating construchon or Iho <br />. ro� /o�r�whc P.�nrcn�ion�rs ���o �nd I�mpJy �dUriho S6 (e�Conlradors��19.� R�CW�and <br />296.200 WAC. <br />'���li� � <br />FEE <br />G►�i�-��G <br />