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 />� " � � L �� �� �- � �"`./�.-! <br />PROJECT ADDRESS <br />�- �, <br />� =-� A 20�, <br />Owner <br />, <br />/`���1 �5��� �� <br />���-.._ <br />�� �ox /ois_ <br />Mail Address <br />City <br />�12;`1�.�� i,�� ��z75'� <br />State/Zip <br />ZS- .� 33 ��3 � <br />Phone <br />,����,� l� wt�� ( 3��-i � � n�,r P� �_��'-�' �`� 1�v-f� ���Zc= � <br />Tenant Mail Address City State/Zip Phone <br />,�� �/ ����j��� ��� c'�j�zi� /of � S� iz���"Sf �-� w� ���%�� �a,���z� �'�� 7 <br />Electrical Contractor Mail Address City State/Zip Phone <br />a <br />%2f� � �S� � � y�Q,2� j l �� � iD� �f; �"�'�' — <br />State License Number Contract Price of Work <br />� <br />� ` � �- <br />Propose Use of Building <br />Contact Person (Plan Review) <br />� a <br />Description of Work to Be Done: � �� ��- (�'' ��� �—' `r���'� ���` �" <br />�.. <br />�'C G-�...�j`"? �=��ii�'C�� GC �� V�' � f ��1�'�,--�'�S <br />, <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 thaf I have read and examined this application and know the same to be true and <br />correct. All provisions oflaws and ordinances govern�ng this type of work will be completed <br />whether specified herein or not. The granting of a perm�t does not presume to give authonty to <br />violate or cancel the provisions of any ofher state or local law regulating construcfion or fhe <br />performance of construcfion. That 1 am authorized by the owner of this property to perform the <br />work for which applicatior�s macYe and ! compl� with the State Contractors Law 18.27 RCW and <br />296.200�V1h�C� , � I % <br />Signature <br />FEE <br />�o�Ua - � �-C Z <br />