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ELECTRICAL PERMIT APPLICaTION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320(1 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 /> ��% ;� ��� us-� � � ��'' ��r � � <br /> PROJECT ADDRESS <br /> � �/ % <br /> Qwner hlail Addrvss Ciry State/Zip Phone <br /> Tenanl Mait Address City State/Zip Phone <br /> YI�tJ�v� ���� ��1 � �CL <br /> Electrical CoMraclor Mail Address Ciry StalelZip Phone <br /> Slale Licensa Numbe: Contract Price of Work <br /> Proposed Use of Buildin� Conlact Person (Plan Review) <br /> Description o(Work lo de Dono: ��' '`�' ��_ <br /> NOTE: WIRING IN NON-DWELLItJGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> I hereby certily thaf 1 have read and examined Ihis applicalion and kno�v fhe same to be true and <br /> co�recL All provisions allaws and ordinances governin�fh�s fype of work�vill be comp/efed <br /> whether speciGed herein or nof. The granfing o/a permd does nol presume fo�ive authonty to <br /> violate or cancel the provisions ol any other sfate or local/aw re�ulafing consfruction or fhe <br /> peAonnance ol consVucGon. Thaf I am authorized by the o�vner ol this property to pedorm fhe <br />! work(or which application is made and I cornply wifh Ihe State Conhactors Law 78.27 RCW and <br /> 296.200 WAC. <br /> , �,/ <br /> i��=�' '�- - <br /> -�<_- � �, <br /> �j- —<-- � <_ �;5. <br /> �Signature Dale <br /> ��SGy-�3� <br /> �� <br />