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ELECTRICAL PERMIT �►PPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, F\/ERETT, WA 98201 <br />425-257-881Q - FAX425-257 8857—www.everettwa.org <br />APPLICAI'IONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� l.`) �i� 7 �'' T � S �' <br />PROJECT ADDRF.SS <br /><-��-/ r�f �`%'�r1i� <br />Owner <br />Tenanl <br />Mail Address <br />Mail Address <br />Ciry <br />Gty <br />StatelZip <br />StatelZip <br />6 �.12. `l2. <br />Gizad-bb� <br />Phone <br />Phone <br />f�/�Fr��r���c— C� �-��. �,o. �Scn J.3 t v /-t4 �; ZY C�' � 3�o-G.`�_z�°. <br />� ., � GI< �l' fl- �I %.. ") <br />Eledrical CoM�acto� Mal Address Cily State/Zip Phone <br />Qa �l�<< �li3/'�l <br />State License Nuinber <br />� p V`l <br />Proposed Use of Building <br />Square Foolage (If residenlial new construction, remodel or addition) <br />Description o( Work to 8e Done: s�" ��� � �5� <br />NOTE: WIRING IN NON-DWELLING;� �S REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 heret,-• certi(y that I have read and examined (his ap�lic� <br />correcL AR prov�sions o( laws and ordinances govemmg <br />whetherspeci�ed herein ornoL The gianting ol a permd <br />violate or cancel the provisions o(any other s�ate orlocal <br />peAemiance o(constnichon. Tlrat 1 am authonzed by Ihe <br />woric (or which applicahon is made and 1 comply with the <br />296.200 WAC. <br />iow fhe <br />work w <br />�/�' �'�? - � � <br />Signature Date <br />2ZD0 � <br />Cantrect Price of Work <br />Contact Person (Plan Review) <br />�EE <br />� 5� <br />co Plet d and � 1 2 �`� —�`�' � <br />ie authonty to <br />tian or the <br />o perloim fhe <br />8.27 RCW and <br />