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ELECTRICAL PE�2MIT APPLICATION <br />CITY O� EVERETT PERMIT SERVICES <br />32;)0 CEDAR STREET, EVERETT, WA 98201 <br />425-2F7-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Z� C�D 2"1 ��' �� IU � <br />PROJECTADDRESS <br />�', <br />Owner <br />Tenant ' <br />Fit�O-�CQ-ci El �^C -(T r <br />Electrical Contractor <br />Mail Atltlress <br />Mail Adtlress <br />i�U �t <br />Mail Address <br />)�'` �S l. <br />Cily <br />� 1 �� <br />City <br />�� �3 <br />Cily <br />� , . , � .. .. <br />RD��1N�Tc�St\Kc �5���� <br />State License Number <br />�. �h,9-�o �C� ���.�� <br />Proposed Use of Building <br />StatelZip <br />Slate/Zip <br />Phone <br />Phone <br />3C�0, (z <br />Phone <br />.��s, <��n <br />Contract Pnce of Work <br />R� Dn.�Qa,�� <br />Contact Person (Plan Review) <br />�- . . . .:• �. • I /� / �� <br />c <br />� � - l.� � �� �� .�� � I�� � .ia .1 <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 certily thaf 1 havo read and examined this <br />corrocL All prowsions o/laws and ordinances gov <br />whefher speci/ied herein or noL The granfing ol a <br />violato or cancel the provisions olany ofher state � <br />pedormance ol construction. That I am aufhorizec <br />work lor which applicafion is rnade and I compty tv <br />296.200 WAC. <br />.��„ir %�i�,J � <br />and know the same fo be true and <br />ypo ol work will be complefed <br />o nol presume to give aufhonty to <br />�egulafing construchon orthe <br />�-3/-d8� <br />FEE <br />\\SC.� <br />Fcfd��,- 0`E ; <br />