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i <br />�y ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 f� a-I��/ <br />425-257-8810 - FAX 425-257-8857 —www.everettwa.org �//D/ ��� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />u/�/ Th � / <br />� ( � % ��� 5 f �"V <br />PROJECT ADDRESS <br />� �;{ S/ �; C('f `i9 nLC� <br />Ownet Mail Address <br />Tenant Mail Address <br />�- � ��'l�R s<�,v �C,�_�7n�.L �ac <br />Electrical Contraclor Mail Address <br />�� f�� 1'�= 1 0 U u 15 C <br />State License Number <br />�� � !� <br />Praposed Use of Building <br />�1 r �� r /✓� :-� <br />Descriplion of Work lo Be Done: <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 />I hereby ce�ii/y that I have read and examined this applic <br />correct. All provisions oflaws and ordinances goveminc� <br />whefher speci6ed herein or noL The granting of a pernut <br />violate or cancel the provisions of any other state or local <br />_ �.., ,�.. <br />.�. � <br />z�r•� / t'. <br />and <br />City <br />State2ip <br />City `1���U°� State/Zip <br />� 3�Z I( 32 ��( �_.� 5• �.% <br />City State2ip <br /><.sF <br />Contract Price of Work <br />Contact Person (Pian Review) <br />e to be irue and <br />completed <br />ve authority to <br />tion or fhe <br />'o peAorm the <br />' 8.27 RC W and <br />FEE <br />Phone <br />Phone <br />Phone <br />� <br />���b�-�`�13 <br />