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�- <br /> ELECTRICAL PERMIT APPL,►C:ATION <br /> CITY OF EVERETT PERMIT SERVIC�S <br /> 3200 CEDAR STREET, EVERETT, WA 99201 <br /> 425•257-8810 - FAX 425•257-8857-www.everettwa.org <br /> APPLICATIUNS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> �� � ) � � ii ' � AA� � � � � � � ( <br /> PROJECT ADDRESS <br /> Owner hlail AOCress <br /> Cily S�ale/Zlp Phone <br /> it ��i � <br /> � �, � � <br /> :� .' � . � � ( � ` �� � <br /> � 1 Jl � � � � � � '!� , i A i : fil Stalelllp Phono <br /> �enanl � MailAdtlress Y <br /> i / '. � , ( I � r � <br /> . ., , , r L C � •\ ��. -i: ��. .. <br /> � , - � � � � �1 � � ' � ��-`���`��{ •��, <br /> ���Y Slate/Z�p Phone <br /> IElecincal ConVactor dad Aaniess <br /> , �' � . C ( - <br /> �, � �. '� � ,' , � � '.1_ Conlrad Price of Work <br /> Sta'.e Lic^nse Number <br /> — Contact Pers�n (Plan Rewewl <br /> Proposed Use ol Bwlding <br /> . , , ..(� (�� � t � � � �_ <br /> � Descnption of Work to Be Done�. 1\ � 1 ' � ��1 <br /> i J <br /> � l ' ' � Illllil ! l .l <br /> NOTE EIRN RACEWAYS MCLO AC CABL�EUIRED TO <br /> FEE <br /> ICITY OF EVERETT LOCAL SALES TAX CODE IS 1105 <br /> I he�ohy cortdy Ihaf 1 have�ead and exorninod fhis app�icalion and knoiv tho same fo 6o true and <br /> carecl All provisions o!laws and ordinancos govsnuny Nus iYVo^��vork wJl be complefed <br /> In�hofher specdieA Feroin or nof Tha g�anGng ol a permR Uocs nof/vusume fu give aufhonty lo <br /> violate or cancal N�e`�rovia�ons ol any ofher slato or local law rogu almg conslnicfiorr o�tho <br /> pcAo�manv w consfnicUon That 1 am aufhonzod by fh�ownor ol this proporty fo porlo�m fho <br /> worM !or wl�ir.h appl�cafion is made nn�1 comply wAh fhe State Conhacrors Law 18 27 RCW and <br /> 796 200 WAC. : , <br /> � � � ` <br /> � 1 . ' �' <br /> � � <br /> � Date <br /> — 9gnalwe <br /> �� �..� �7'�� ' � � � <br />