Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />'--f 5G� I in - �.�`L2- <br />PROJECT ADDRESS <br />Owner <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 />Mail Address <br />City <br />`"`„'7.. <br />State/Zip <br />Phone <br />���ZL t�� \/ �",chS��`'�j, �� IV�i �� U��'v9� I) l.J�,p, <br />Tenant Mail Address City State/Zip Phone <br />�.<�, �(j,;� 1 ��� <br />��t�il�}�fc',�c'�� �iv�lh�����;� c�s�h� r����_ r'�f,S�k �:�,,�� `�-(�4�,�� �z5�3,�,-;� <br />Electrical Contractor Mail Address City State/Zip Phone <br />%�I�U �,/�� i S �i 7 f� C'S <br />State License Number <br />'--� <br />�Si� LL�� � <br />Proposed Use of Building <br />Description of Work to Be Done: -�✓�-!� / 1,�4 Cl_ ���"J <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 />� ���� `'� <br />Contract Price of Work <br />Contact Person (Plan Review) <br /><. r►o (;�.� J iz G (f. �' )7 <br />I hereby certify fhat 1 have read and examined this application and know the same to be true and <br />correct. All provisions of /aws and ordinances governm� th�s type of work will be completed <br />whether speafied herein or not. The granting of a perm�t does not presume to give authonty fo <br />violate or cancel the provisions of any ofher state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which applicati ade and / comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />�-, <br />. , <br />' / _._- <br />/ �\ �, (` -> � <br />�� ��,,��� <br />re <br />Date <br />FEE <br />��(o -�/� <br />��N �, <br />