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�.�w��_ <br />� <br />�ECTRICAL PERIViIT AP ICi4TION <br />CITY OF EVERETT PERMIT SE VICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />ELECTRICAL APPLICATION INFORMATION <br />CONTRACT PRICE OF WORK: $ �L% � <br />NUMBER OF DEVICES if low volta e: <br />FIR.E ALARM? ❑ YES ❑ NO <br />ASaOCIATED BUILDING PERMIT # (if applicable): <br />DEaCRIPTION OF WORK: �� <br />type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or <br />local law regulating construction or the performance of construction. That I am authorized by the owner of this property fo perform fhe work for which application is made and I <br />comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br />Agent Signature <br />�� � � ���>> � . <br />Date <br />City of Evereft Official Use Only <br />FEE <br />�� � <br />�� , <br />PERMIT # <br />E� ;�(�- ��- <br />(Revised 10/12/2015) <br />