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ELECTRICAL PERMIT <br />CITY OF EVERETT PERNINT <br />3200 CEDAR STREET, EVERETT. <br />425-257-8810 - FAX 425-257-8857 - vnvw.everetiwa.ora <br />APPLICATIONS ARE ACCEPTED FROM <br />APPLICATION <br />SERVICES <br />WA 98201 <br />8 AM TO 4 Prl <br />PROJECT ADDRESS <br />c J)y oA <br />Ovmer Mai Address G:y <br />StateMp Phone <br />Tenant Mail Address City <br />:�.Js <br />Staie2ip Phone <br />ElectncalContractor MaiiAddress City <br />11io <br />Slate Limnse Number <br />Proposed Use of Building <br />Description of Worn to Be Done' <br />Slate2p Nona <br />Contract Price of Mrlc <br />I <br />Contact Person (Plan Review) <br />r'CTE: WIRING IN NON-DVVELLINGS IS REQUIRED TO <br />BE IN RACE%%fAYS, M.- OR AC CABLE. <br />FEE <br />I I I <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certih, that I have read and examined this aop!icalipn and knmy the same to oe true and <br />correct Al provisions of laws and ordinances governrtg this )pe of v✓ork vr'II be completed <br />whalther speci5ed herein or not, The gran5ng of a perm:: =a% no! orescme tc gwe a:rhori:y !a <br />violate or canoe! the provisions of any other state or Iccai iaw raauianng ccnstruclion or ire <br />partorr ante of caustru tion. hat I am authoriTd by ;ha owner of this pro to form the <br />work for which application is made and ! comply th the State COntracta-s e 1l;. -form and <br />233.200 Vu'AC. <br />