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C���`{ �3 <br /> a���5� ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> �'a� 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 - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> 1 1��i �i�.'r.ru� �-✓�� �i/.���C G�'� � <br /> OJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Tenant tvlail Address City Stale/Zip Phone <br /> nl�' �ct��/�v <br /> /c�eclrical Contraclor Mail Address City State2ip Phone <br /> State License Num6er CoNracl Prica o(Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> i <br /> Description of Work to Bo Done: I�l.�I�I�� .��. `��� / � <br /> NOTE: WIRING IN NON-OWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �ITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi(y that I have read and examined(his application and know the same fo be true and <br /> correct. All provisions ollaws and a�dinances govenung O�is type o(work will be complefed <br /> whether specilied herein or noL The c�ranting o/a perm;t does not presimie fo give authonty fo <br /> vielate or cancel tha provisions o1 any other state or loca!law regulating construction or the <br /> perlormance oI construction, Thaf 1 am aufhonzed by fhe owner o/this property to peiform fhe <br /> work for�vhich a ' ation is rnade id 1 compl}��vifh the Sfafe Confractors Law 18.27 RCW and <br /> 29fi.200 WA . �� <br /> � <br /> / �_�� � y �a��S <br /> �jd �__ Date <br /> L����D ��¢ � <br />