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i " <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.averettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> ��14� yt.�c��� <br /> PROJECT ADDRESS <br /> �— /� —} p <br /> �_ ,(i�cS K . � blC��O$1-�. (��� , t�jc,C ��L` -�.� � �L.,""1 �1 �l b�Zc�+ <br /> �e� � Mail Aedress Ci <br /> N State2iP Phone <br /> Tenant Mail AdCress Ciry State/Zip Phone <br /> �c��l ,�M� <br /> EIecMCal Coniractor Mail Address City State2lp pho�e <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to 8e Done: �%��r�,�_ L•'�� `=> �\c��; cti����'��- � �t c� ' <br /> _ J <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CQDE IS 3105 <br /> I hereby certily that/have read and examined this application and know the same fo be true and <br /> correct. All provisions ol/aws and ordinances govemin,q th�s type ol work wil!be completed <br /> whether speci6ed herein or noL The granting o/a permrt does not resume to giva authonty to <br /> violate or cance/the provisions o(any other state or/ocal/aw reguPting consWction orthe <br /> wo�k lo awh ch appl/cation�s�made and I comp/y with ihe State Cont actosPLaw 18 27 RCW and <br /> 296.200 WAC. <br /> - -` _� <br /> �� -., � <br /> _ _%" � `_ .3 � -C� <br /> Signature � Date <br /> '�--- -� Eo5c3 -a�((o <br />