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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everethe�..org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />-��'b2- S„..�5E-T �pn/G , CV�.-►'1�i� <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />Eledrical Contractor <br />Mail Address <br />Mall Address <br />Mail Address <br />r� 1�5tli�JU�ov �1� <br />�'ate Lfcense Number <br />Proposed Use af Bullding <br />Gty <br />Clty <br />State2lp <br />, <br />5,57.2• 2� <br />CanVact Pdce of Worn <br />Contad Person (Plan Review) <br />Phone <br />Phone <br />Phone <br />Descriplion of Work lo Bo Done: Ic.C.�Zt �✓` L��S ��� W/�-�- �a-*�-E •��37�'i2'L <br />.dLkl��J 17�.5f/ l,i f! � I.CSS l�G�'� �C_/i11� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />or <br />read and examined this application and know the sama fo 6e hue and <br />iws and ordinances goveming fhis type of worrc will be complefed <br />r not. The granNng of a permit does not presume fo glve authority to <br />rions oI any ofher stafe orlocal law regulet7ng corsWcflon or the <br />�n. Thaf I am authodzed by the owner o/ thls prrperty to pedorm the <br />�' ma�leerrd�l-cornplywithfhe-6teto-6orttrec(oiatew-f9-�R6H`end' <br />�I ��Iz�, Z <br />FEE <br />5�/�� <br />� l 20�{ -Oq 3 <br />