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� <br /> ELECTRICAL. PERMIT APPLICATION <br /> CITY OF EVE�tETT 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&CREDIT CARDS ARE NOT ACCEPTED <br /> �I �ia7 ��I�er l,q�-e D� <br /> PROJECT ADDRESS <br /> C'�F Q f �✓F'r�f 1 O�Z C Mk�NPf7 W//�]� V'� 257� O.N / <br /> 1 - <br /> Owne,- Mail Address Cily StateZp P�one <br /> Tenanl Mail Address City State2lp P��e <br /> ���w <br /> Electrical Contraclor Mail Address City StatelLip Phone <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Pereon (Plan Review) <br /> Description af Work to Be Done: �// ��,� ��-�X��� <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that 1 have read and examined this application and know the same to 6=hue and <br /> correct. All provisions o//aws and ordinances governing this type o(work will be complefed <br /> whether specrfied herein or noL The granting ol a permd does not p�e�me to give authonty fo <br /> vio/ate or cancel the provisions o(any other state or local law regula'in construction or the <br /> peAormance o/construchon That 1 am authonzed by the owner of th�s property to peAorm the <br /> work lcr which application is made and 1 comply wdh the Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �,u.� ��-��---- �- 3�o� �./3� <br /> Signature Date CO � <br /> F <br />