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; <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, �VERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8657—www.everetlwa.org <br /> APPLICATIONS ARE A�CEPTED FROM 8 AM TO 4 PM <br /> ��C � ��, i�ii i ti <br /> PRPJECT ADDRESS <br /> /7�Ia�/� <br /> Owner Mail Address City Stale2ip Phone <br /> Tenant Mail Address City Sta1elZip Phone <br /> [ledrical CoNraclor Mail Address City Slate/Zip Phone <br /> Slate License Number ConUscl Price of Work <br /> Proposed Use o(Duilding Contacl Person (Plan Review) <br /> i�9 <br /> Description of Work to De Done: �l' �y' <br /> � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY QF EVERETT LOCAL SALES TAX CODE�S 3105 <br /> I he�eby cer7ily thaf I have read and exarnineA fhis application and know the same to be true and r ���� �? l,' - 1 ��(7 <br /> conecL All piovisions ollaws and ordinances�ovemmg this type ol work will6e comp/eted � <br /> whether speci6ed hcrr,in or noL The g�anfing o/a permd does not resurne to give authonty fo <br /> violate or cancel the provisions ol an ofher sfate or local law mguPting construcfion o�!he <br /> peAonnance o/consfruc(ion. That 1 m au(horized by Ihe owner ol this property fo perform tbe <br /> work lor which apPlicafion is rnade 3nd(comply wifh fhe Sfate Contractors L•dw 78.27 RCW and <br /> 296.200 WAC� , � <br /> / , <br /> �,: /� � �- /S�_�� <br /> �' - <br /> Signaturc Dsle <br />