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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERV{CES U-� - iI <br />3200 CEDAR STREET, EVERETT, WA 98201 r�� a 4, p'� ,% <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org � <br />�1 2`� C Ir"Ci,'ic� <br />PROJECT ADDRESS <br />j.'.� ��� ��i� rl1 <br />Owner <br />Tenant <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� L <br />� a� <br />Mail Address <br />Mail Address <br />,� -�� r15a1 CJC�e �1 �, <br />City Stale/Zip <br />Cily Stale2ip <br />Phone <br />Phone <br />�►Mm�� �ec�-a'; c <br />EleClrical Conlractor Mail Address City Slate2ip Phone <br />Slate License Nwnber <br />�`l"� <br />Praposed Use of Building <br />Descriplion of Work to Oo Done: I� i' �� �CC �t �� <br />�VC���,Lc\ S(%�\U�..CC _ <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWA�S, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I heroby c�rtily thaf 1 have renA i <br />corn�cL All p�o��isions olla�vs a� <br />�rhetherspeci6ed herein ornof. <br />viola(e or cancel fhe I�rovisiona c <br />performm�ce of construcfion. Th <br />work !or �vhich plication is ma� <br />296. 0 WAC. <br />� <br />� � <br />S nalure <br />fhis <br />comply <br />� <br />`�' �� S �O <br />Contract Price of Work <br />Conlacl Person (Plan Review) <br />and know the same fo be fn�e and <br />ype ol work will be completed <br />natl�rosume fo give authonty to <br />egu afing wnstruction or fho <br />er oI this property fo peAonn the <br />Contractors Laiv 18.27 RCW and <br />FEE <br />ac:o PmP <br />F_►�vK-o3� <br />