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ELECTRICAL PERMIT APPLICATION <br />CITY OF 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 <br />,;i� __.'�� � �'�I,JI-�/�� �� <br />— � <br />PROJECT ADDR�SS <br />_ ^I. t `-j` 1_1\i..\\\t,_`.� <br />O�vncr Mail Address <br />Tenant <br />Mail Address <br />Cliy <br />Cily <br />�1--8�0� <br />!-r��r�--65a- <br />�-� ? �; � � � i-� �Si - � �7 L ; �+ <br />State2lp Pl�one <br />SlateZp <br />Phone <br />�,V'\C� l�iV�V'I � �C'l�:A \l � �1�-� � =`�' 1-I��`�ii <br />Electrical Conlrac�or Mail Address Cily Slate/Zip p��p�a <br />'� �� ��.�'-i �_. �U �-�_-''.l�i�-' �-' ;�� � 1 <br />Stale Ucense Nurnber � <br />Proposed Us� of Buildin� <br />Doscriplion o(1Nork l0 6c Donc: <br />NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABL[. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Conlrecl Piice of WorY, <br />CoNacl Person (Plan Review) <br />I hereby ce�tily fhat 1 have read end exemined fhis application nnd knrnv the sante to be true and <br />conect All provisions ol lar�s and ordinances got�e�aing ;his I}�pe ol work will be cornp/eted <br />�rhefher specified herein or noL The �ranfing o/ a penruf does nof n�esume fo gire aufhonty (o <br />violafe or cancel fhe/� rovisions o/ any ofher stafe or local la�v re�ulating construcfion or the <br />� ork for7�ti��h ch appl ct'f uI �'s nm'de ond�le ompty ��fb Ih'e�State CorihacfoisPLaiti 18 27 RCl1�'anA <br />29G.200 11�AC. <br />/ . ,' <br />' % �i�-.�� - <br />—� � i >" _% � A/ V � i � <br />FEE <br />�;� ,-. --- <br />�� � _ <br />