Laserfiche WebLink
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 />, i �, � ���� <br />P OJECT ADDRESS �� <br />� <br />S5� �r1j`�",� 1 <br />Owner <br />� <br />Tenant <br />, �,( �`� , �� <br />Mail Address <br />Mail Address <br />�� c'�i L 1-- ���.�L�+�,` % � �,�; <br />City <br />City <br />State/Zip <br />State/Zip <br />�) � �.�� --S ���t- <br />� <br />���� Z.� <br />Phone <br />Phone I <br />: i,�� ���i -� �� C�.� v►�- ��rJ,��{�R.�,� �.�� <br />EleCtrical Contractor Mail Address City State/Zip Phone <br />�� <br />State License Number <br />�.--�� - �� �- �,,.,�, �� <br />Proposed Use of Building . <br />I% �J� �lt,tiL�-�.> <br />Description of Work to Be Done: �. Q(_,�� P+-�fL.� <br />-- lu ��.�.'�.� i�.� ✓� <br />�5 f /� � <br />1 ; .� l /,� <br />Contra�t Price of Work <br />,J Po� �, r2��ti► �� � �><� <br />Contact Person (Plan eview) <br />l� � -� - i�,� ��> G��� � �, L� l� � ,� �.,� <br />i2 , + � � �/� '�-� J,� � <br />,�„�;� 1 <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that 1 have read and examined fhis application and know the same to be true and <br />correct. All provisions of laws and ordinances governrn� this fype of work will be completed <br />whether specified herein or nof. The granting of a permit does not presume to give author�fy to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construcfion. That I am aufhorized by the owner of this properfy to perform the <br />work for which application is made and 1 comply wifh the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />\� <br />FEE <br />_� ��� <br />�!L-��-IU� <br />