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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��C�4 C� ,����-��� � <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Electrical Contractor <br />State License Number <br />Proposed Use of Building <br />Description of Work to Be Done: <br />Mail Address <br />Mail Address <br />Mail Address <br />rJ� / � <br />City <br />City <br />City <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />State/Zip <br />State/Zip <br />State/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerfify thaf 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governin� fhis type of work will be completed <br />whether specified herein or nof. The granfing of a perm�t does not presume to give authorify to <br />violate or cance/ the provisions of any other state or /oca/ !aw regulating construction or the <br />performance of construction. Thaf I am authorized by the owner of this property fo perform fhe <br />work for which application is made and I comply with the State Contractors Law 98.27 RCW and <br />296.200 WA C. <br />9 c /� / �/" � � �G %l <br />FEE <br />Phone <br />Phone <br />Phone <br />