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( <br />ELECTRICA� PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �3 _�� <br />3200 CEDAR STREE'i , EVERETT, WA 98201 � <br />425-257-8810 - FAX 425-257-8857 —www.everettwa.oro �� 208—p5 3 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�, �70 2 �DC�'��-�--� �2 <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />Mail Address <br />Mail Address <br />SS77J ���,-��c��� <br />Contrac�or MailAddress <br />�.C�.SS� L �Qi�7 (�C'-�- <br />State License Number <br />r� 'i-�r 1 �Cr � — <br />Praposed Use ilding <br />Square Footage (If residential new consiruclion, remodel or addition) <br />Oescription of Work to Be Done: <br />� <br />NOTE: WIRING IN NON-DWELLINGS IS RE(lUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby certify thaf 1 havo read and examined this applia <br />correct. All provisions o/laws and ordinances goveming <br />whether specified herein or voL The granting ot a pertmt <br />violate orcancel tlie provisions o/any otlierstt�te orlocal <br />pedormance o( onsfruction. That 1 am authonzed 6y tlie <br />wo�fc for which s,�plicafion is made and I comply �vifft the <br />296.200 WAC. <br />, ��� <br />City <br />Ciry <br />City <br />�2�=�sz -�� / <br />StalelZip Phone <br />StalelZip <br />SletelZip <br />�`�_'�.O `� <br />Contract Prir� of Work <br />Conlact Person (Plan Review) <br />�� <br />know fho same to 6e fruo and <br />o(work will be complefed <br />Presume to give authonty to <br />ting construction or fhe <br />lthisp roperty fo per(orm the <br />�tractors Law 18.27 RCWend <br />�l�a���_ <br />Phone <br />i � <br />Phone <br />FEE <br />�5°� <br />�lz�g "�5� <br />