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( <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �` <br />,✓ <br />3200 CEDAR STREET, EVERETT, WA 98201 � I <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�" CSZF���-Le%Y)m <br />PROJECT ADDRESS <br />Ownor <br />Tenant <br />Mail Address <br />Mail Address <br />Eleclricai Contraclor Mail Address <br />State License Number <br />Proposed Use of Building <br />Description of Work to �e Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />Gty <br />City <br />City <br />State2lp <br />Slate/Zip <br />Slate/Zip <br />Conlracl Price of Work <br />Phone <br />Phone <br />Phone <br />Contact Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hero6y certi/y that 1 fiavo read and examined fhis applicafion and know the same to be frue and <br />corroct. All provisions ollaws and ordinances govemmg flris type of woric will be completed <br />whefher specified herein or not The aranting ol a permd does not �resume to give authonty fo <br />violafe or cance/ the provisions of any other sfate or local law reguleting construction or the <br />performance o/ consiruction. That 1 am authorized by fhe owner o( this property to perlo�n fhe <br />work lor which application is made and 1 comply with the State Contrac(ors Law 18.27 RCW and <br />296.200 WAC. <br />j ' <br />;�/ � ���,�� C - 7 - � �u <br />� <br />FEE <br />�� � <br />�'l G'i,� ' �i� L _7 <br />