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ELECTRI�;AL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-II857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� � �{�('�� � � <br />PROJECT ADDRESS <br />Tenanl <br />� �i <br />61ail.1tldress <br />Mail AdAiess <br />Cily <br />Cily <br />Slale/Zip <br />sc�i��z�� <br />1/-iz-a0 <br />�/O // �-D (� � <br />�as <br />Phane <br />Phone <br />��,ss�� �i��-��s. � o. ��`t� s���rPit wo �4�� g� :�?`�-��1 <br />[ledrical Conlraclor tdail Address City SlatciZip Phone <br />%l��sSzT � S3�'�t <br />Stalc License Number <br />��P';� (�PtiC � <br />Proposed Use ot Ouilding <br />Descriplion of Work to �e Done; <br />NOTE: WIRING IN NON-DWELLINGS IS RE�UIR[D TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />s�/ //°�i`� -- <br />Coniract Price o( Work <br />Conlact Person (Plan Review) <br />FEE <br />y ccitily fhal 1 huve iead and examined this application and know the same lo Ge fnie and /�� �� �` � 0 <br />. All piavisions olla�rs und ordinances qoverning Ihis t}�pe el trork tvilf be cempleted �J <br />v speciGed herein or noL rhe 9ranting ol n pernut does nof resurne lo �ive authoriry to <br />or cancel (he I�ro��isiuns o/ an}� other sfafe or local law re,quPfing construclion or the <br />iance o� ���nstruction. That 1 am aufhorizc d by the o�vner oI this property to pei7orm the <br />�r �rhich application is made and 1 comply �vdh Ihc Sfa(e Contractors La�v 18.21 RCW and <br />/ �/^�I2."' � <br />Date <br />