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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 />^ � <br />PROJECT ADDRESS <br />Owner <br />, <br />Tenant <br />Electrical Contractor <br />� <br />State License Number <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />Mail Address <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />C ity <br />City <br />C ity <br />State/Zip <br />State/Zip <br />State/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Phone <br />Phone <br />Phone <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �`,1 �� <br />�.r V, <br />I 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 cance/ the provisions of any other state or /ocal law regulating construction or the � <br />performance of construction. That I am authorized by the owner of this property to perform the E�� y� —�j o�� <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Signature <br />REVISED 3/20/13 <br />Date <br />