Laserfiche WebLink
FROPI :POINTEk-ELECTRIC FRX N0. �360 757 2681 Nov. 1� 2006 07:58AM P1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CI7Y 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 ACCEP7ED FROM 8 AM TO 4 PM - DEBIT& CREDl7 CARDS ARE NO7 ACCEPTED <br /> 11 �as �� ��r �" �oac� <br /> PROJECT ADDRESS <br /> �e.n �l� a��lNf-Jao,h.P.,Q �I� �X�Sdoy' <br /> O� Mait Atld1ess Ciry � Stete/ZIP Phone <br /> n - �'�e,,�,� I I S�� Ae r�+ �� C� Rla 9�r a-o�F <br /> TeneOt Maii Adtlrese Clty Slete2lp phone <br /> Q� �n+c,r �1-e.c�r�� ia�us R¢.c� 2� �'�ere.� cJ A qga3� 3� ?�o� <br /> Electrical ContraCtor Mall Address City Stata2lp Phone <br /> z / _�J�' l$�? . vo <br /> State License Numoer Conhact Pnce of Work <br /> .oposed Use uf 6uilding Contact Person (Plan Review) <br /> DeScriptlon of Workta Be Dona; �(S 4�/1(12G� Ire GL7A����� IIeQ.�.� �TW <br /> (`L/hoc� �ewlr-e So,n�o /`QDlc o.�,o � 0,�; /1 <br /> -r- • T .. <br /> NOTE: WIRING IN NON-DWELLING515 REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE <br /> CITY OF EVERETT IOCAL SALES TAX COpE IS 3105 <br /> 1 hereby certlly that I heve read and exem/ned fhls applicatlon end know the sama to de true and <br /> correct All proNs/ons of/aws e,�d ordinances govaming this type ol work will be completed <br /> whethe�speci/ied hereln or not. rhe grenHng o/e permit does nof presume to give a.vthonty to <br /> vlolate or cancel iho provlslons of eny other sfate or loca!law reguleting cons[ruction o�the <br /> pedormance o1 consPructlon. lhaf I am aufhorized by the owner o/fhls property to peAotm the <br /> work lor whlch applicatlon!s made end I compty wJth fhe Slate Contreofors Lae 18.27 R.CW end <br /> 29B.200 WAC. <br /> 1 �- 9-06 '' <br /> , <br /> 3lgnature Oate I , � <br /> �. � � ' , V�� <br />