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�LECTRICAL PERMIT APPLICAI ION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98207 <br />425-257-8810 - FAX 425-257-8857 - www.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�;,z 3 : � �'.��- r �� ���� f� �f����. <br />PROJECTP,DDRESS <br />� <br />I )fJGll ��i ��'�1 ji/:l��.. <br />Owner MailAddress Ciry Stato2ip Phono <br />Tenant <br />Mail Addross <br />Mail Address <br />/l )n,��l�%P��iS�71'll __ <br />gtate U �i rs Number <br />Proposed Use oi Buildirg <br />Descnplion ol Work to Be Dane: <br />Ciry <br />City <br />State2ip <br />St�te2ip <br />Plione <br />�'�6 - <br />�� <br />Phone <br />�� <br />'�(�i l, C�/�,fC�,l� <br />� <br />Contact Price of Work <br />Contad Person (Plan Review) <br />NOTE WIRING IN NON-DWELLINGS IS REQUIR[D TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EJERETT LOCAI SALES TAX CODE IS 3705 <br />1 here6y caMily fhef I heve reed and eaemined fhis epplicehon end know the semo ro be true end <br />correcL .qll pmvisions o/feu5 end onlmences govemmg fhls type o/work will be complefed <br />whefherspeci(ed herein or noL The grenhng ol e permrt does nofpresume to gve eufhonty to <br />violate or cencel fhe provisions ol eny ofhersfefe oNocallew mgu�efing�� t ycfion�orthe <br />pedartnence o/ construction. 7het 1 em euthonzed by fhe owner of fhis ert fo dorm fhe <br />work (or which apphcefion is me�e end 1 comply wifh fhe Sfete Confracfors Le�.✓ 7827 RCW end <br />?96200 WAQ . <br />� �� <br />� �"� �,". (�—'- <br />/ <br />9 <br />F rX9o3 — �5 � <br />