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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 -tvww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> —= f 61ST <br /> PROJECT ADDRESS <br /> .10M �IA1' 4ZS <br /> "�r' Cj.1 5zo3 3. 617 <br /> Owner Mall Address City State/Zip Phone <br /> Tenant Mall Address Clly State Zp Phone <br /> Electrical Contractor Mall Address <br /> City Slate21p Phone <br /> Slate License Number Contract Price of Woo <br /> Proposed 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 /> I <br /> CITY OF EVERETT L CAL SALES TAX CODE IS 3105 <br /> I hereby certify that 1 have road and examined this appliration and know the same to be true and <br /> correct. All provisions of Jews end ordinances governing this Type of work Kitt u,:completed <br /> whether specified herein or nof, The granting of a Permit does not ppresumo to give aufhonty to <br /> violate or cancel the provisions of any other state or local law reguraYnq construction or the <br /> Performance of const�cflon- That I om oufhonzed by tlme owner of this roperty to perform file <br /> work for whichap�licti ion Is made and I comply with the Stale Contractors Law 18.27 RCW and <br /> 296.200 W C. <br /> Signature <br />