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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 />Owner Mail Address City Slate/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor Ma' Address City � State/Zip Phone <br />FTtC/ac'f`�DO� /tqrO <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low vo;tage) r/ <br />Description of Work to Be Done: <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 • Gf <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 cancel the provisions of any other state orlocal law regulating construction or the <br />performance of constmction. That I am authorized by the owner of this property to perform the <br />work for which application's made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Sig Date <br />REVISED 7/26/0 <br />