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ELECTRICAL PERMIT APPLfCAi"ION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, [VERETT, WA 98201 <br />425-257-8810 - FFUC 425 257-f3857 — wewi.evereriwa.org <br />APP�ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />I��IG�R-c'.GK.e�—�CIIe,� r�tv-� <br />PROJECT ADDRESS <br />Tensnt <br />Mail Address <br />Mnil Address <br />Ciry <br />_ ���-u� <br />-l� <br />Slale2lp <br />State2lp <br />Phonr. <br />Pho�m <br />�l��v� i`t��l�'c;i1r� � l�tr�i�N1(Ut.%�c-�v 1�4=. �Z�.,�'y������'S)� �1 ���(0,�1�5��iVl C-�,Ci�1 <br />Eloarical Contraetor rnan naaress Ciry Staierzip �non� <br />% 2��v ; N �:-1 , �t L�3 C`iT� <br />State License Numbar <br />1� ! � I (���(;"�'t I C�� <br />Proho6ed Usa af Builtling <br />Description of Work to Oe Done. <br />- � "-�, � b�i�l�b��ncarv-1 �� �� r,�,u.--l— � <br />NOTE: WIRING IN NON-DW[LLINGS IS REQUIREU TO <br />BE IN RACEWAYS. MC OR AC CABLE. <br />CIN OF EVERETT LOCAL SALES TAX COD[ IS 3105 <br />s read and oxamined this <br />la�t�s nnd oidinanc�os gov <br />bTi <br />q �-!`•C'0 • CCj <br />ConUact Pnca ot Work <br />�ll I l t�f • Ll�� � C—tY�. �i�f �Z <br />Contnd ersnn (Plan Review) <br />and kno�v tho same !o bc frue anJ <br />ypn o/�wrk �vill br, cnrnpNtotl <br />� not p�osun7e to give authorty lo <br />rgulntinn conshuctian Or tho . <br />ivu�k Por �yhich applicatrori is nidde and I comply wRli the-Sfate Contrac(ors'Ca�'v 1827 RCW and <br />FEE <br />Fo7aa-c;3y <br />,�.f�;�,'.��. „r.��l �JI;:il'J3�3 h�Ir����J� ;•t5t,:�iEn���, TT:613 �n�i�'.i�i)i�'n <br />