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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 />APPLICATI lNS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARUS ARE NOT ACCEPTED <br />�- "� - `� � � � . �r � ti-� � � l l_ �/ !� <br />PROJECT ADDRESS <br />� -�� �I����'...,., �� �:1�`� C�L-y`b�,��L �L�f� CLJ� i'S'>2� �/�\_'\S"�( <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />Electrical Contractor <br />State License Number <br />Praposed Use o( Building <br />Description ot Work to Be Done: <br />Mail Adtlress <br />Mail Address <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BC IN RACEWAYS. MC GR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Ciry <br />City <br />State/Zip <br />State/Zip <br />Contract Price of Work <br />Contact Person (Plan F<eview) <br />I herebvi certily that 1 have read and exammed this application and know the same to be true and <br />correct: AU provisions ot laws and ordinances govemrng this type oI work will be completed <br />whether specdied herem or not The granting ol a permd does not presume to give authonty to <br />✓wlate or cancel the provisions o( any ofher state cr local la�v regulating construction or the <br />pedormance cl consfruction. That 1 am au(horized by the owner ol this propeRy to peAorm the <br />work lor �vhich application is made and 1 cemply wdh the Sfafe Contractors Law 18.27 RCW and <br />29G200 WAC. �' <br />; / <br />� �/ ( � <br />� _ . __ •- ;' \_� - �_ > - �� .- L � — <br />C("�i �� i1� (� <br />FEE <br />:��� � _ ��G' <br />Phone <br />Phone <br />