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ELECTRICAL PERMIT APPLIGATION <br />CITY OF EVERETT P�RMIT SERVICES <br />3200 CEDAR STREET, EVERETT, �VA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIOIvS ARE ACCEPTED FROM d AM TO 4 PM <br />% B � ��-��l � U� ,� <br />PROJECT PDDRESS � I <br />W� �� �!fr'1� �'j�_ B��' � / �� /� <br />� .1��'Ir 1— �� C1(�� �� �V� ��� W <br />Owner <br />Tenant <br />o w N�2 <br />Electrical ConUaclor <br />Slate License Number <br />��OC.C� <br />Proposed Use of Building <br />Mail Address <br />Mail Addrecs <br />Mail Address <br />Descriplion of Work l0 6e Done: �J� <br />NOTE: WIRING IN NON-DWELLIIJGS IS REQUIRED TO <br />66 IN RACEWAYS, A1C OR AC CA8LE. <br />CIT`! OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily that I lmve read <br />correcL All provisions o(laws a <br />whefher specilied herein or not. <br />violate or cancel the pr'ovisions <br />perforrnance of construction. T <br />work lor �vhich app�ication is nr< <br />296.200 WAC. ` <br />this a�: <br />goverr <br />�lape <br />3te orl <br />ized b: <br />Iv �vifh <br />Cily <br />Cily <br />Cily <br />�-a�(-�z <br />�l �Z01-b85 <br />�� z�i s�Q <br />2�7-� �/� � <br />Slate/Zip <br />Stafe/Zip <br />Stale/Zip <br />Contract Price of Work <br />Contacl Person (Plan Reviaw) <br />�- n Un� '� iZoO� <br />m and kno�v fhe same fo be true and <br />s f}�pe of Krork will be completed <br />�es not r'esume to give authonty to <br />w reguPting const�uchon or the <br />,vnar o( this property to perform the <br />�te Contractors Law 18.27 RCW and <br />l, <br />FEE <br />Phone <br />Phone <br />Phone <br />�l 2ot - o�S <br />