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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-25'-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />GG� � L .1v = <br />PROJECT AD RESS <br />Mail Address <br />City <br />State2ip <br />�, L 99�/ <br />Phone <br />�l �<— <br />Tenant Mail Address City State/Zip Phone <br />��r/.T/ � <br />Electrical Contractor Mail Address <br />State License Number <br />Proposed Use of Building <br />Description af Work to Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />� <br />State2ip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />I hereby certily that I have read and examined lhis application and know the same to be true and <br />correct. All provisions ollaws and ordinances govemmg this type ol work will be completed <br />whether specified herein or noG The granting o/ a permif does notp resume to give authonty to <br />violate or cancel the provisions of any other state orlocal law regu/ating construction or the <br />perlormance of construchon. That 1 am authonzed by fhe owner oi ih�s property to pedorm Ihe <br />work !er which application is made and / comply with the State Contrectors Law 18.27 RCW and <br />296.200 WAC. / i <br />/, <br />FEE <br />� o9lG-G( `� <br />Phone <br />