Laserfiche WebLink
i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVIC�S <br /> 3200 CEDAR STREET, EVERETT, WA 982U1 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM - DEBIT & Cl2EDIT CARDS ARE NOT ACCEPTED <br /> S�S6� FI'Entr�EYr� W�y <br /> PROJECT ADDRESS <br /> Ownef MailAddress City SWte/Zip Phone � <br /> (�/`�1vn(1111f� �f A'(Al� 984o uiLloNS 20• �/•f• ��oL (�Dh�u✓D l�'� ( y1f"� 76/�`191f — <br /> Tenant Mail Address City State2ip Phene <br /> ,�Mlc,r,c1 sr�� �a�P �Lf�'w�J1cM�f M� �✓ stir/f�E � ��r�9 �2�/� �8z-arv0 <br /> Electncal Contractor Mail Address City State2ip Phone <br /> _L✓/t�liSCP�IM� � <br /> State License Number Co�act Price of Work <br /> OF�GIG� �U Jin� ST��� Z�d�al.�,✓ <br /> Proposed Use of Buil ing Ccntact Person (Plan Review) <br /> Description of Wark to Be Done: �'�N47�— 7i+/O t✓�'^" WA'+'�- 5��`�S• l'��T'� /f&� p��� <br /> g�6r/ CPGi�� Ft�dK��^P 7r l-X�Jy�✓� .sr6�✓ Crrtcyi>} <br /> ; <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED �0 FEE <br /> BE IN RACEWAYS, MC OR t;C CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE !S 3105 <br /> I nereby certifv fhat 1 have read and examined this application and know th�same fo be true and <br /> correct. All provisions ol/aws and ordinances govemmg this type of werk will be comp/eted <br /> whe�her specified herein or ot. The granting o(a permd does not presume to oive authonty fo <br /> violate or cancel th provis'ms o(any other stata or local law regu/ating aonstruchca or the <br /> performance of co struct� . That/am authonzed by the owner oi !n�.nroperty to pe�f�^m the <br /> wcrk for which ap licatio s made and 1 comp/y with the Stafe Cont�acfbrs La�v 18.27 R�W and <br /> 296.200 WAC. <br /> N,L7-or �;7 ' � <br /> Signat e Date ��, / <br /> ,��l/ <br /> / �) <br /> ;!; <br />