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r <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 <br /> �(Z� / � <br /> PROJECT ADDRESS <br /> Owner Mail Address City State2fp Phone <br /> Tenanl Mall Address City State2ip Phone <br /> Electrical Conlraclor Mall Address Cily SWIe21p Phone <br /> Stale License Number Contracl Price of Work <br /> Proposed Use of Building Conlact Porson (Plan Review) <br /> Descriplion of Woiic to Be Done: �_/� ,C � �� �O �� v�� <br /> NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS,PA�OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify Ihat I have read and examined this application and knoH�the samo fo be true and � <br /> correcL All provisions ol laws and ordinances govemmg this type of woric will 6o complefed � <br /> whether spec�lied herein or noL The granfing o/a pemu(does nof resume to givc aathonty fo <br /> violate or cancel the provrsions ol any olher sfafe or local law re,quPting construction or the � <br /> performance oI construcfion. Thuf 1 am aofhonzed 6y fhe o�+�ner oI this property to perform fhe I O� <br /> work for which appl;,:ation is mado and 1 comply�vith the Sfafe Confrec(ors Law l8.27 RCW and /1 <br /> 296.200 WAC. � <br /> , <br /> ° (�g�- � ( - Z3 - 1 ( <br /> Signature Date <br />