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� <br />ELECTRICAL PERMIT APPLICi�TION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEF.ETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�Li'(�� /'% `T�o�c�� �/ %v'� <br />�o <br />PROJECT ADDRESS <br />�� <br />Owner <br />Tenant <br />Mail Address <br />Wtail Address <br />r� ` � ��6 <br />-�__���Y <br />%�f.�'ei1 ��t�CJ"/i G -l-qG 1��l�.f' Z.Zy� <br />Eleclri 1 Contraclor Mail Address /� <br />/�c �,' ��bI2 lv <br />State L cense Numbe � <br />5r`itti%e ��� <br />Propose Use o( Buitding <br />Descriplion of Work to Be Done: <br />City <br />�/, <br />State/Zip <br />State2ip <br />Stale2ip <br />/�Do <br />o� <br />Contracl Price o( Work <br />Contacl Person (Plan Re�iew) <br />Phone <br />Phone <br />Zp6 <br />Phone <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT L7CAL SALES TAX CODE IS 3105 <br />1 hereby certi(y fhat I have read <br />correct. All provisions ollaws a <br />whether soeciCed herein or nof. <br />fhis <br />a <br />FEE <br />and knoiv the same to be true and <br />ype ol work will 6n complefed <br />nof presume to give aufhonty to <br />egulating consfruction or the <br />er ol this property to pe�form fhe <br />Confractors Law 18.27 RCW and <br />/ za� <br />�OSGB-f�Z' <br />