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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 ACCGPTED FROM 8 AM TO 4 PM <br />' ��0 Z l.v. �'l� � �'/ �'o <br />PROJ[CT ADDRESS <br />��(� L�ocf4ti;�'�,'�i <br />A4ail Address <br />qty <br />Tenant Mail Address Ciry <br />�^Y"� l2(' ��' C 1�'iC l I�.S� S�.� �,%�i <br />Eieclrical Conlractor A9ail Address ���Y <br />� YC�l�Gt'�' � 9� S/�-1 K <br />State License Number <br />S i��� yl�° �'I G�e�, ; /� ���eic'/i'ti � <br />Proposed Use of Buildinc� ' <br />/'L('/�lJ Z,O�t�.(, <br />Description of Work lo �o Dono: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceriily that 1 have read and examined this applia <br />correct. All provisions ollaws and ordinances go��ermng <br />�ti�hefher specilied herein or noL The �ranfin� ol a pernut <br />violafe or cancel the provisions ol any ofher stafe or locai <br />peAormance o! construclien. Thaf 1 am nufhonzed b}� fhe <br />�vork lor whicli applicationf�ade and 1 cornpty �vith the <br />296.200 WAC. � � <br />,%'�,//`� 1 <br />��5�30� �� <br />State2ip <br />Phone <br />State/Zip Phone <br />;v% ���� 9�3/ <br />State/Zip Phone <br />�� S3� 677 73 <br />Contracl Price of Work <br />Conlact Person (Plan Review) <br />� � <br />G�/ r',�j <br />know the same to be frue and <br />of work uill be cornpleted <br />' presume to give authority fo <br />�lating cons(ruc6on or the <br />I this property to pedonn the <br />ntraqtors La�v 1 27 RCW and <br />/� <br />'o� o� <br />FEE <br />�=c:��� -0�5 <br />