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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 d AM TO 4 PM <br />/ `//y SU•r�( s <br />PROJECT ADDRESS <br />E�ciS s�7T c 93�3 iG pL Nc" �Af:�'s-i�v�,rs G�A 9Ba�3 •/x�=3NEoti33 <br />Ownet Mail Address City State2ip Phone <br />Tenant <br />Electrical Coniractor <br />License Number <br />Mail Address <br />Mail Address <br />ADtI�T �AMiw KoM�= <br />roposed Use of Buil ing <br />City <br />Gty <br />Stale/Zip <br />Slate/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Wark to 8e Done: /� i�D l 3, J vp�.T �M � f:F �¢ L,�R/H 5 <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 />1 he�eby certily fhat 1 have read <br />correct. All provisions o(laws a <br />whefher specifieAherein or not. <br />violate or cancel the provisions <br />per(omiance oI constniction. ri <br />work lor wfilch applicatron is ma <br />296.� 00 WAC. <br />� �! � <br />lhis <br />comply i <br />and know <br />�7-�C�- /U <br />s fo be true and <br />completed <br />ie authonty to <br />tion orfhe <br />o perform the <br />8.27 RCW and <br />FEE <br />Phone <br />Phone <br />F l DO�j —a �L 8 <br />