Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY QF EVEl2ETT PERMIT SERVICES <br /> 320C CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-i3810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> � ti i)ri E�PrarPer, le/n,� C�ere � l✓� y�za3 <br /> PROJECT ADDRES <br /> Sfeve� 4Z. I�Ir ,.� <br /> Owner Mail Address City SW;e/Ztp Phor.e <br /> �..<r �Dr:se �eh7 " �; 'CAr <br /> Tenant Mail Address CIty Slate/Zlp Phone <br /> I�i ;���»c � So�� L-. /ec'�rr� ��.fJ. �oY ZO �L�1 �tllF4,'r lw/1� S�SZ,P �3l.U)27S-S,}�� <br /> Electncal onlractor Mail Address Clty / State2ip Phona <br /> � �N ,�� se ,,sM � 2U��-� it �o <br /> State License Number C /f'�I o�G nTPrice of Work <br /> � �/ � <br /> C4r QPti7G�S <br /> Proposed Use of Building Contact Person (f-lan Review) <br /> DescriplianofWorktoBeDone: /��� 'GOO�t 3u�esr SPVv;Ce a�.c� /� c�rcti;{s <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FE� <br /> BE IN FcACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> 1 here6y certi(y that 1 have reed and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances goveming this type of:vork will be comp/eted <br /> whelher specified herein or not. The grenting cf a permit does not presume fo give authonty to <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> peAormance o(censtructlon. That I am authorized by the owner of this propeity to per(omt the <br /> work!or which application is made and I complv with fhe State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �.� �,� 11- 03- v � <br /> 'ignature Date <br /> L'���—C�/� <br />