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ELECTRICAL PERMIT APPLICATION <br />� a/is� �� <br />C- I I I Z-�'�� <br />CITY OF EVERETT PERMIT SER�'ICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wt�,nv.everettwa.org <br />APPLICATIONS ARE ACCEPTED FRO�d 8 AM TO 4 PM <br />7�OG�0 �vG� U���� W� � <br />PROJECT ADDRESS <br />��/��r�` G�LiiV��' <br />Owne� Mail Address Clly Slale2ip Phone <br />Tenant <br />Mail Address <br />�� <br />Electrical Conlractor Md' Address <br />��rl�lz�%Nl �jDG ./3 <br />State License Number <br />City <br />71 0 0� S � <br />Proposed Use of Bufldfng <br />Descripllon of Work to Be Done: �D I CG ll � I � <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 cerlily that I Irave read <br />conect. All provJslons of laws s <br />whefher specified herein or not. <br />vlolate orGancel fhe provlslons <br />performance of construclion. T <br />work lor whlch application Is np� <br />29G.200 WAC. �— � <br />this application and <br />Clty <br />� <br />State/Zip <br />Slato2lp <br />Contract Price of Work <br />Conlact Person (Plan Revie�v) <br />�h��N` �t o�--" <br />�'�-- N� ti-� <br />FEE <br />3 fo 6e frue and <br />complefed <br />�e aufhonty to <br />fion or the <br />Phone <br />Phone <br />RCW and <br />I � — � �� <br />�� ll <br />