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( , <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-3810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> � .�'��/� <br /> -' 7 .� � � t�f;� .�_T�,12,r.i� t i' t� .1, � j <br /> PRC�JECT ADDRESS � <br /> /1�2i..... �n TiyL'r�.SY ! <br /> Owne� Mail Address <br /> City Slate2ip Phone <br /> Tenant Mail Address City State2lp Phone <br /> /��„ ✓ ��... n i{. �� �� /`/Y!� �n !- <br /> Eleclrical Con.ractor ` Mail Adtlress Ciry State/Zip Phone <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: [� ,,-.� /V;�--�„i /�/��-y,-� <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 /> l hereby certily�hat I have read and examined this application and know the same to be true and <br /> correcL AI!provisions ollaws and ordinances govemrng this type ol work will be completed <br /> whether specified herein or not. The granting ol a permd does nof presume to qive authonty to <br /> violate or cancel the provisiens of any other state or local law regulating construction or the <br /> wo�k%wh ch app4cati�on s made and I comply w thlhe State Contra�ctosPLaw 78 2 RCW and <br /> 296.200 WAC. <br /> � O/� 0� /v/i � /v!! <br /> SignaWre �� �� // --/ <br /> roy��g� <br />