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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERIl91T SERVICES �' _�_,o <br />3200 CEDAR STREET, EVERETi, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org �(01( `��� <br />PROJECT ADDRESS <br />Tenant <br />Electrical Contractor <br />Slate License Number <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Mail Addross <br />Mail Address <br />Mail Address <br />Gly <br />City <br />City <br />� <br />State2ip <br />Slale2ip <br />Slale2ip <br />Contract Price oi Work <br />,�yf _�Y <br />?�� <br />Proposed Use of Buil�inc� Conlacl Person (Plan Review) <br />Phone <br />Phone <br />Phone <br />NOTE: BERN RACEWAYS MC OR ACICAB �UIRED TO <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this applicatior and kno�v Uie same fo be truo and <br />con�c,. All provisions o/ /aws and ordinances goveming fhis type of �vork will be complofed <br />whether specified he�ein or not The granting o/ a pennif ooes not presume to givo authonty fo <br />violate or cancel fhe r�rovisions o(any ofher stafe or local law regulafing consWcfwn or f.9e <br />' perfomiance of construcfion. Thaf 1 am authorized by the o�sner of this properiy to pedorrn fhe <br />work (or which applicafion is rnade and I comply wifh the Sfate Confrac(ors Law 18.27 RCW and <br />2ss.2oo wac. �� ' y <br />,�'�.�,��� �> _ � L �a <br />FEE <br />1���—� `�3 <br />