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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT. WA 98201 3-11–a} <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org ��� 3_.()U3 <br />APPLICATIONS ARE ACCE?TED FROM 8 AM TO 4 PM <br />2 ~/,'�-G G,���-�m���e ,�l vt <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Electrical CoNraclor <br />Slate Licr,nsc Number <br />Proposed Usc ol DuilAinp <br />Descriplion o( Work to 6e Done: <br />hlail Address <br />A7ail Address <br />?✓1� I � /�0%',' <br />A1ail Address <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIREL� TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Ciry <br />City <br />�,� <br />SlatelZip <br />Slale2ip <br />Sla�e2ip <br />�.�7. °% <br />Contract Pri e of Work <br />Conlact Person (Plan Review) <br />I hereb}- certil�� thal l have reaAand exnmined fhis application anAkne�v the same to Ge true and <br />coner.(. All provisions ol laws and ordinmrces 9overning this type o! �vork wil/ be cornpleted <br />whether specilied heiein or noL The g�antin� ol a perrnR does nof �resume to give authonty fo <br />violate or cancel (he provisions oI any other s(ale or locnl law regulafinq consWction or fhe <br />perlormance oI ccnstmction. Thal I am aufhorized by !he mvner o/ flus property fo perform the <br />�vork lor.�rfiicli applicalron � r��de and I compl}� u�ith the Sfafe Contractors Law 1827 RCW and <br />FEE <br />/T ? <br />�at� /��U, q'> <br />l <br />Phone <br />Phone <br />Phonc <br />