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ELECTRtCAL PERMIT APPLICATION <br />CITY OF EVEFtETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLI�:ATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />�{3v ��Rr�►,��.t�w� <br />PROJECT ADDRESS -r <br />��-���� y� r7 �� <br />Owner Mail P <br />� ��SS � � �� �i3c� <br />IM�-. <br />Electric2l <br />�ceH ��v� W f� 98'�3 389'YS %T <br />�—r City SWte2ip Phone <br />��� c�.�,�(w�r,� �u.�'v�— G�Ek— `I� 239-sY�t3 <br />Maii Address <br />��.S��s �60��� <br />Mail Address <br />�����Q 1 a-�- l <br />Slate License Number <br />�,�`( c C��-� <br />Proposed Use of Buiiding <br />Description of Work to Be Done: �`^ <br />Ciry <br />State2ip <br />Phone <br />.�� fl�,�.���r����wl� q92�S <br />City State2ip ��_(�z(lPhirt! � <br />7� <br />��% <br />Conlract Price of Work <br />1�^� � �KC "l <br />Contact Person (Plan Review) <br />( �.�.,�( S«e � <br />NOTE: WIRING IN NON-DWELLINGS IS REG�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceRi(y that 1 have read and exs <br />correct. All provisions o(laws and ordrr <br />whether specified herein or noL The gn <br />violate or cancel the provisions of any o <br />per/ormance of construction. That 1 am <br />work /or which application is made and , <br />296.200 WAC. <br />,. . � � 0 <br />fhis application and know the <br />goveming this type o(work w <br />�f a nermit does not nresume <br />e to be true and <br />completed <br />�e authonty to <br />tion or the <br />o peAorm the <br />8.27 RCW and <br />FEE <br />L�}%07 ��GJ <br />