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( 1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 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 /> i�U � �wi � <br /> PROJECT ADDRESS <br /> �1/�t U ' / , /�.P <br /> OWnef Mail Address City State2ip Phone <br /> .�L�i� /�,b�c�C� <br /> Tenant Mail Address Cily Slate2lp Phone <br /> V!' .�l`n ti.V <br /> Electrical Contractor Mail Address Clry SWte2ip Phone <br /> �C� <br /> $�2ta Lirensa Number Conlracl Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: — � u � / '�- � Q��' �� <br /> � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf I have read end examined tbis applicafion and know the some to be true and <br /> correcf. All provisions ollaws and ordinances goveming fhis type ol work will be complefed <br /> whether specdied herein or noL The granting o/a permif does not presume fo give aufhonry to <br /> violate or cancel the provisions o/any ofher sfate or focal law reguleting consfruction or the <br /> pedomiance o/constn�ction. Thaf 1 am authonzed 6y the owner o/this propeRy to peAorm the <br /> work lor which applicalion is made and 1 compty with fhe State Con(ractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � <br /> � � -as <br /> Sic�naWre Date <br /> Jv' ? / <br />