Laserfiche WebLink
� s <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT S�RVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICA i IONS ARE ACCEPTED FROM 8 AM TO 4 PM - DF.BIT 8 CREDIT CARDS ARE NOT ACCF.PTED <br /> 5 5os ��er`tePn v�n.y <br /> PROJECT ADDRESS <br /> fc%H �. �(�� Y�. �x 38�D �✓eiet� UJ�" �8103 fZS�S!•03� <br /> Owner MailAtltlress Ci1y SlatelZip Phone <br /> �v�i'���t��,ri se ��-G-C4r 5505 �verr�reeti WQ�, �Ve��Ulf`' 9�3.?03 <br /> Tenant MailAdaress Cily State2ip Phone <br /> r rw,a�cP �PA.TiYl.9 �6{� S• (�0� `�. �ie/�,�f tJ>1- 98o3Z ¢,25•%•J1•03� <br /> ElectricalContractor MailAddress City StalelZlp Phone <br /> P�P��o�FkOo 5BS ��� <br /> State License Number Contrad Price of Work <br /> p�� /�r�. �i���'�r <br /> Proposed Use of Bi:ilding Contacl Person (Plan Review) <br /> Description of Work to Be Done: (�15�L` 1 �� `D w �O L(�Qe �`�I�t05�`i,l` <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 certi/y Ihaf 1 have 2ad and examined fhis applicafion and know Ihe same fo be trus and <br /> conect. All provisions ollaws and orclinances governing fhis type ol work will te comp/efod <br /> whelher speci(ed herein or nof. The granting o/a permd does nof resume to give aulhonfy fo <br /> violafe or cancel lhe.provisions ol any ofher sfate or local law reguPfing consfrucfion orfhe <br /> pedormance oI constroction. That 1 am authonzed by fhe owner o�this property lo pedorm Ihe <br /> wopr for which applicalion is made and 1 comply wdh Ihe Stafe Conf2ctors Law 18.27 RCW and <br /> 296.200 W4C. <br /> ���� '� <br /> Signature Dale <br /> Ed4tf-( 4� <br />