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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREZET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED i i'OM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />, :�Z02 S E_ <br />PROJECT ADDRESS / <br />/ Owner Mail Address City Stale/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor Mail Address City Slate/Zip Phonc <br />Stale License Number Contract Price of Work k <br />P•nposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />,31TY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 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 or work evill be completed <br />whether specified herein or not. The granting of a permit does not ppresume to give authority to <br />violate or cancel the provisions of any other state or local law ragulating construction or the <br />performance of construction. That I am authorized by the owner of this properly to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />J <br />Signature Uate <br />L^t <br />