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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 8 AM TO 4 PM <br />PROJECT ADDRESS <br />om Lav,e- <br />Owner Mall Address City Slateop Phone <br />Tenant Mall Address City State/Zip Phone <br />PQw2/ iSlPr 11'I C // 3Y45 //rh Ale u/�fi r>�'2�1 <br />Ldectrloal Contractor Mail Address City Slate/Zip Phone <br />os <br />State I icense Number <br />/4/e i C.fr1"ly <br />Proposed Ustf of Building <br />l - <br />Descriplion of Work to Bo Done -� r <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 hereby certify that 1 have rend and examined this applic <br />correct. All provisions of laws and ordinances govemin9g <br />whether specified herein or not. The granting of a pemnit <br />Contract Price of Work <br />r) r�ty. 1?fAl J <br />Contact Person 113Ian Review) <br />1) <br />and know the same to be true and <br />ype or work will be completed <br />not presume to give authority to <br />e rof thi 8 deity fo perform the <br />Contractors Lew 18.27 ACW and <br />(') /I `1 / 6 <br />FEE <br />rd <br />