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� � - <br /> ELECTRI�AL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA �82J1 <br /> 425-257-8810 - FAX 425-257-8857 —www.everetiv�a.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> n <br /> ,f i/J /d ✓';�'r ,- �i��5c* /� /' �, ��'S <br /> PROJECT ADDRES� `� ` <br /> ���_,_r_�!r �n�ar ,�-;S r'� <br /> Owner MailAddress City EcatelLip Phone <br /> Tenant Mail Address City Slate2ip Phone <br /> r � � � <br /> ��^ /" ��iC/�/J .l+:�"t ,�'/!'_ f/1/' <br /> Electrical Contractor � Mail Atldress City S1ate/Zip Phone <br /> State License Number Contract Price of Work <br /> Proposed Use ot�uilding Contact Person (Plan Review) <br /> � <br /> Description of bVork to Be Done: � •i- -t� �� .r' � i fif.:Ir�! <br /> NOTE: �VIRING IN NON-DWELLINGS IS REQUIRED T�J FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceRi7y that I have read and exammed ihis application and know the sam,e to be true and <br /> r.orrecL A;l provisions o/laws and ordinances gcveming this fype oI werk will be completed <br /> whether specilied herein or net The granling ol a permR does not presume fo give authcnly fo <br /> violate or cancel the provisions olany other state or locallaw regulating consWct+on or ffie <br /> peAoimance ol construction. That!am authonzed by the owner o(fhis property to peAorm;he <br /> �vak lor which applicution is made and I ccmply wifh the Stafe Centractors Law 78.2i RCW and <br /> 296.200 WAC. <br /> � /, / <br /> '�,�r�G /"� �1 / ���.t�J� <br /> S— ignature �� ' ��%� j D e <br /> � ���' -�'�� <br /> � <br />