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ELEC�RICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98209 <br />425-257-8810 - FAX 425257-8857 — www.evereltwa.org <br />APPLICATIONS ARE ACCEPTED Fi�OM 8 AM TO 4 PM <br />�35 D��n��P! �. � �V) <br />PROJECT ADDRESS <br />I�� �nA?� �dn1-3-3� a��n��� �. <br />p�r,.r�p,� Mail Addms.s G�N <br />�.'.Il.v�r 1�:� t7��?V-4—� �' <br />TenaM <br />Elect�ical <br />NIaII Addmsa <br />M1ail Addtess <br />�t2���1 ?�?'� <br />State Licen e Number <br />��� 1 �� (11'� �— <br />Pro sed Use of Building <br />r. <br />Cily <br />Cily <br />Sla[dZlp <br />rr r+ <br />SlatdZip <br />r�� , �in� <br />sim�zw <br />lo�a�` �� <br />El�(D -ll5 <br />r� <br />3 Z.$�I – S� <br />Plqne <br />/ � <br />���x�z�2 <br />�L�- 9 z5a <br />� <br />'�' L�� � P���_ <br />CoMrect Price of Work <br />�.dc�.AeT�rr� ����rnr� <br />Contact Person (Plan Review) <br />NOTE: WIitING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />C1TY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby certify that 1 have read and examined this applicafion and know fhe <br />conecf. A71 provivons ollaws an0 ortiinances governing this type o( work w� <br />whether speciTed herein ar rrot. 7rie granling of a pertnit does nof presumo <br />viela[e or cance! the provision5 of any Wberstate oNocal law regu�ating cor <br />� l� <br />�� l <br />ie to <br />: con <br />ive a <br />ction <br />78 2 <br />,� <br />FEE <br />°nd CItID- I►5 <br />to <br />and <br />Z�d 0918-Z98'09E ou�oul�e�g�opwop e6S�60LL1Z1�0 <br />