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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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � � <br /> � l , <br /> PROJECT ADDRESS <br /> � <br /> ;' (.7 <br /> �� <br /> Owner Mail Address City State/Zip Phone <br /> TenBnt Mail Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: C� / <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify fhat I have read and examined this applicafion and know the same to be true and <br /> correct. All provrsions of/aws and ordinances governin�this type of work will be completed <br /> whether specified herein or not. The granting of a perm�t does not presume fo give authority to <br /> violafe or cancel the provisions of any other state or local law regulatrng construction or the <br /> performance of consfruction. That 1 am authorized by fhe owner of this property to perform the <br /> work for which application is made and 1 comply with the Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> V�'� A� � U C��- <br /> Si�na D te <br /> � �. <br /> �-�,��/�' '�� <br />