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a <br /> ,- <br /> ELECTRICA� 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 /> ;�23� �p/�cc�<<t,�, � <br /> PROJECT ADDRESS <br /> Owner Mail Address Cily State/Zip Phone <br /> Tenant Mail Address Cily Slate2ip Phone <br /> Electrical Conlraclor Mail Address Ciry Slate/Zip Phone <br /> 6tale License Numbai Conlrect Price of Work <br /> Proposed'Jse o(Building Conlact Person (Plan Review) <br /> Descriplion o(Work to Be Done: <br /> ��.� �c�d�iZ - �s�l -.SGt� � <br /> ��il�'J� � � VC � ' �J� �-�- <br /> NOTE: W IRING IN NON-DVJELLINGS 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 ceriily thaf I have read and examined this application and know Ihe sarne fo 6e hue and � <br /> correcL All provis�ons o!laws and ordinances governmg Uiis type of�vork will be complefed � <br /> �vhelher speaGed herein or not. 7he�ranting ol a perrnd does not resume to give aufhonty fo 0 <br /> violate or cancel fhe provisions ol any other sfate or local law re�uPtin�consfruGion or the <br /> pedonnance ol consfruction. Thaf I am authonzed by fhe owner o(this property to pe�fonn fhe � <br /> �vork lor�vhich application is made and I comply wilh the State Confractors Law 18.27 RCW and � <br /> 296.200 WAC. �r, <br /> �_ . � � U <br /> ��' -----'`" r%'- %- o S- y . <br /> � Sipnature Dale ,�V <br />