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�LECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAP. STREET, EVERETT, WA 9E201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 FM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />�D/ 9 � %�/ <br />PROJECT ADDRESS <br />� ! 7 / <br />Cwner <br />Tenant <br />Electrical Contractor <br />State License Number <br />Proposed Use o� Building <br />Oescription of Work tn Be Gone: <br />Mail Address <br />Mail Adoress <br />Mail Address <br />NOTE: WIRING IN NON-DWELLINGS IS REaUIRED TC <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />C�ry <br />City <br />Sfate2ip <br />State/Zlp <br />SlaleZp <br />Contrect Price of Work <br />ConWct Person (P�an Review) <br />1 hereby certi(y that I have read and examrned this application and know fhe same fo be tn�e and <br />corrnct. AO provisirns o/ laws and ordmances governing ihis type of work �vJl be completed <br />whefher specibed herem or not lhe granring o/ a permd dces not resume to gi��e authonty tc <br />violate a cance/ fhe provisions o/ any c7her state or local law 2gu atinq construction or the <br />pencrmance ol conswclion. That / am authonzed by the owner oRhis propeRy to periorm the <br />wcrk for which application is made and I comply with the State Contractors Law ; 8.27 RCW and <br />296.200 WAC. <br />� <br />FEE <br />Phone <br />Phone <br />Phone <br />