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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.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT � CREDIT CARDS ARE NOT ACCEPTED <br />3� s o R a�.� ��w v l�vc ,�,�,�el'-F <br />PROJECT ADDRESS <br />c�QaS 83 � �� S 6 ��� <br />��1� L�;•veSfi�tP�T p,¢��.�r�rv z�c _S aoko��-� �J�. ���9n aa�, <br />Owner L <br />Q��� J <br />�,el��j0�e��5h <br />Tenant <br />Electrical Contractor <br />State License Numher <br />Proposed Use of Building <br />Addrens <br />'!_3 8 3 K� <br />Mail Address <br />Mail Address <br />cty <br />v� SL S',��� <br />ciry <br />City <br />Description of Work to Be Done: � C' W SQ ,� () � C G ��JU �. � <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br />I hereby ceRi(y that I have read and examined this <br />correct. All provisions of laws and ordinances gov <br />whether speci�ed herein or not. The granting o! a <br />violate or cancel the provisions o/any ofher state c <br />peAormance o/ construction. That I am aufhonzed <br />work tor which application is made and l comply wi <br />296.200 WAC. <br />W <br />know the <br />o( work w� <br />StateZp Phone � <br />J�, 4S�9a u�5�33y" j4 $ <br />State2ip <br />State/Zlp <br />ConVact Price of Work <br />Contact Person (Plan Review) <br />s to be hue and <br />comp/eted <br />�e authority to <br />'ion or the <br />� pedorm the <br />8.27 RCW and <br />FEE <br />c`�9D�' /.3/ <br />Phone <br />Photie <br />