Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY t�F EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8657 — www.everettwa.org <br />APPLICATIOhS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� � L; � � < � - �L �. _ ; t �, �- _ <br />PROJECT ADDRESS <br />', .�., - �.[�07 `.�,,...' :_t��r.-�•r' <br />OWnef � MailAddress <br />� �-1-ono�s Ch�nese ReS��t <br />� c -+ i � i .,� ; �- . .,_� ,-� G <br />Tenant Mail �ddress <br />r <br />! ,�-�+11�<<l �Ui�';i__�Y����� � �„-,,.� �,. ,.� <br />Electrical <br />Address <br />-� I T 5-! -�-c--�g-C� � n�n; ne � <br />State License Number <br />F� 7 �. <br />/--" • !c i !�y �j �' 1..�-� / c i' <br />Proposed Use of Building <br />Square Footage (If residenlial new conslruclion, remodel or addilion) <br />Descrip�ion of Work fo Be Dane: <br />' NOT[: WIRING IN NON-DWELIINGS IS REQUIRED TO <br />3E IN RACEWAYS. MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />Ciry <br />City <br />State/Zip <br />S�ate/ZiP <br />State/Zip <br />Contract Price of Work <br />Contact Person (P�an Review) <br />FEE <br />5O � <br />Plione <br />Pnone <br />Phone <br />1 hereby cedily th�t l have read and examined this applicalion and 6now flie sarne to be liue and � I� r ^�� <br />conecl. All provisions olla�vs and ordinances govemmg (his fype oI �voik u-ill be canplefed �Q <br />whefher specified herein or noL The granting of a pemuf does not presume to give aufhonty fo <br />violafe or cancel fhe provisions ol any other state ar local laiv iegulating consWc6on or the <br />peAomiance of conslniction. That 1 am authorized Uy fhe o�vnero/flusp �operty Io perlonn the <br />work (or �rhich application is made and 1 comply wifh fhe S(ate Conlractors Law 1827 RCW anA <br />296.200 W/lC. <br />.1� .�Itr'' ;ri� � � �j -,. . <br />� Date <br />SignaWre <br />