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ELEC�'RICAL PERMIT APPLICATION <br />CITY dF 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 - DESIT & CREDIT CARDS ARE NOT ACCEPTED <br />�yZ �� �<� 1C� r'tc I �e� <br />i�� �l�d. .�G1` 5 1. 5� <br />PROJECT ADDRESS <br />I-��a�.� ���. �NST. 3�aa g�+,.A�E. �,E �� ���T , <br />Owner �1ail Address Ciry <br />Tenant <br />Eleclrical Contractor <br />Slale License <br />Propased Use of Buiiding <br />Mail Address <br />Mail Address <br />Cily <br />Citv <br />Descriplion of Work to Be Done: 1 L-M � ��" C L <br />NOTE: WIRING IN NON�DWELLINGS IS REDUIRED TO <br />BE IN RACEW%�YS, MC OR AC CA6LE. <br />�� u�aos y25- 3�l-� 360 <br />StalelZip <br />Slate!Zip <br />State/Zip <br />Contracl Price of Work <br />Contact Person (Plan Review) <br />FEE <br />CITY OF EVERETT LOC aL SALES TAX CODE IS 3105 <br />1 hereby certi(y thaf I havo read and examined fhis application and know fhe same fo be true and <br />correct. All p�ovisions oi la�.vs and ordinances �overning this type o/ work wd! Ge completed <br />violete orPancel�h,eeprov siors o(any oth�er state o� local �a�v reguPt rig consh9,:hon or they �� <br />peAormance o( construchon. That i am authonzed by the owner o/ this property� fo perform the <br />�vork lor which application �� made and I compty �vith ihe Sfate Contractors W�v 1827 RCW and <br />296.200 WAG �� � <br />(-3c�-oS <br />.�,�-� <br />;- /�--- <br />Phone <br />Phone <br />Phone <br />