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___� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF �VERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-SFi10 - FAX 425-257-8857 —www.everettwa.org <br /> AP!'!JCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> ._��;� �� �'t ��' -�-�J/� <br /> PROJECT ADDRESS <br /> �, <br /> �� � /� <br /> Owner Msil.4ddress City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> l� <br /> Ll-�-`�„�- ,/�'�� � -�� <br /> Electncal Contractor Mail Address City Stalc/Zip Phone <br /> State License Number Contraci Price of Work <br /> )/ %�� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> / <br /> Descriptian of Work to Be Done� L�.�i /�-� �� G�c% /j <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> ; <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> i <br /> CITY OF EVERE'iT LOCAL SALES TAX CODE IS 3105 �i <br /> !hereby certily that 1 have read and examined this application and know the same to be true and <br /> ccrrecL All provisions of/aws and ordinances goveming this type o(work will be completed I I <br /> whether specihed herein or net. 7"he granting o/a permrt does notp resume to give authority to � <br /> violate or cancel the provisions of any other state or local law regulating construchcn or the � <br /> perto�mance ol construction. rhat 1 am authonzed by the owner e(this property to perlorm the � <br /> work(or which applicalion is made and 1 comply with the State Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � /,--��'_..�, � �G- . �� ... <br /> � Signature � Date <br /> EOSGZ-U��; <br /> I <br />