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` �'�""`� ELECTRICAL PERMIT APPLICATION <br /> r�{,. <br />`�=°�- CITY OF EVERETT PERMIT SERVICES <br />;,, <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-88"0 - FAX 425-257-885,' —www.everettwa.org <br /> APPLICATIONS ARE ACC[PTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> $`� ZI y� r" S� S � <br /> PROJECT ADDP,ESS <br /> � � � -- -- <br /> Uwner � Mail Address Ciry Siate,'Zip Phone <br /> Tenant Mail Address City State/Zip Phone . <br /> �`t�� .�, �v\.`�r �`e� I <br /> Electrical Conlractor Mail Address Ciry S�ate/Zip Phone i <br />����'y,���. <br /> b"�'�� State License Number Contrecl Price of Work I!I <br />'':a:`"�'y. I <br /> '�� Proposed Use of Building Contact Person (Plan Review) <br /> `J <br /> Description of Work to Be Done: 1 C r''�P ���� <br /> NOTE: WIRING IN NON-DWEI.LINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLG. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi(y fhat/have read and examined fhis application and know fhe same to be true and <br /> correcL All provisions of laws and ordinances govermng this type o/�vork will be comp/eted <br /> w.hether specilied herein or noL The granting oI a permd does not presume to give authority to <br /> violafe or cancel fhe provisions ol any other stafe or local law regulating construcfion or the <br /> peAormance of construcfion. That/am authorized 6}�the owner o/fhis property to perlorm the <br /> work for which application is made and 1 comply with th�Slate Contractors Law 18.27 RCW and <br /> 296.200 WA%� <br /> �/�� , Z � rf"� <br /> � <br /> Sign re �� r Date <br /> �- C:�{ l� -I1� <br />