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ELECTRICAL PERMII' APPLICATIO�N <br />CITY OF EVERETT PERMIT �ER�ICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />- � <br />� � '� y, �i - i � <br />�).' � C- �.v � e ,�; <br />PROJECT ADDRESS � � <br />Owner <br />Tenant <br />� I <br />= I �;y��11 :','� <br />Elec!rical CoNractor <br />"� . , ��a�d - � <br />�_. ]v�� t, S�l <br />� Mail Addreso <br />A1ail Address <br />� _ <br />r�7T`" i��' %�C(Al�'6'_ <br />Mail .qddress <br />�'�i�J�•�;�li���-i.�C�., �� �i. <br />State Licens� Number <br />Proposed Use o( Building <br />Descriptioc of Work to �e Done: ;' i ;� <br />NOTE: WIRING IN NON-DWEI_LINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />, <br />, 4'. ; r - <br />.(,ePe�l 6✓�, , ��:n . ;'�.� <br />Ciry � Slale2ip Phone <br />I <br />Cily <br />r' <br />State/Zip <br />:��`' <br />City � '� � Stale/Zip <br />' . JJ <br />"L„ <br />Conlract Price of Work <br />r—. <br />_�� �i�i I ���1���,r <br />Conlacl Person (Plan Review) <br />',v'�,. .,� <br />� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certity tha( I have read and examined this applicatron and know the same (o be (rue and <br />conecL All provisrwu ollaws and ordinances governmg this lype o( u,rork will bo cornplefed <br />whether spec�fied herein or not The granfing o/ a pernut does not presume to give authonty te <br />violate or cancel (he provisiau oI any other sf�te or local faw regu/ating construction or the <br />� o�k lo av6 ch appl c�t�fioii�s n a/ de and I co�mplyedf� fhe S7afe Con(racPrsP a�y18 27 RC W and <br />2ss.zao wac;. <br />,,, <br />-- � ; .�:- � i � ;�i `� �, � �% <br />�ignature i , Dalu.- <br />�- �--_ _ _ <br />�� , <br />Phone <br />� . � � <br />4"�� -u�f <br />Phone <br />FEE <br />� � <br />