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I <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.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 6 CREDIT CARDS ARE NOT ACCEPTED <br /> '��l%� iiro`n_��auP�, ) <br /> PROJECT ADDRESS <br /> Owner A1ail Address City State2lp Phone <br /> Tenanl Mail Address Cily Slale2ip Phone <br /> Electrical Conlrector Mail Address Ci�, State2ip Phone <br /> Slale License Number Contract Price o(Work <br /> Proposed Use of Building j Conlaci Person (Plan Review) <br /> �– - <br /> '�. <br /> Description ot Work lo Be Done: ./lf��/,�����,�LC�_-L <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily Ihaf I have read and examined fhis applicafion and kno�v Ihe same to be true and <br /> conecL All provisions ol/aws and ordinances�overnmg Ihis type ol�vork will be completed <br /> whelher specdied herein or noL The c�ranting o/a perrnd does not reswne fo give aulhonty to <br /> vio/ate or cancel fhe provisions ol any other stafe or local la�v re�uPting consWcfion or fhe <br /> peAormance o/construction. Thaf 1 am aufhorized by the o�vner oI this propeRy to peAorm the <br /> work far u�hich applicafian is made and I comply�vith fhe State Conlractors La�v 18.27 RCW and <br /> zss. oo wg � <br /> % J . <br /> _� <br /> �� � , .C�_�� —,� � ,-r �� <br /> � Sig ture —� Date � � � <br /> � <br /> i . � <br />