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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> PROJECT ADDRESS <br /> OwneMail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> � I <br /> Electrical Contract r Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> / <br /> <e.1 -0 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Nu er/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: <br /> FEE �{ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> ►•r 1 rr <br /> l hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the E <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and 6V <br /> 296.200 WAC. <br /> igna re Date <br /> REVISED 08/06/2014 <br />