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.everetiwa.org �—(3�0 —7 <br /> APPLICATIONS ARE ACCEPTED FRO!�i 8 AM TO 4 PM �'D�0 6—D '7 <br /> Z/Cq�' l3 �' i.�i-�1 G�l� <br /> PROJECT ADDRESS <br /> Owner Mail Address City State2ip �,s Phonn <br /> 13��' /� l��LE'�Yc:o �(vd' 13h�•4U[tirFr' �ll �.Y,�.o� y2J� �^3°D' <br /> Tenanl A9ailAddress Cily 51atc/zip �/1� Phone <br /> �}�LN N�r � ma. L� s` �?�� r (iia ..�� I���n�.��'��L�I �s�' �,�GI <br /> Elect�ical Contraclor A1all Add�ess Cily Slate/Zip Phone <br /> l-�_..o- ys,�, ,�. <br /> Slale License Number C�ntracl Price o1 Work <br /> � k'll�i�� rs <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Description of Work lo Oo Dono: �O/L11�G�1��f��� 2��/T3� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC GR AC CABLE. L L ��C �, <br /> � <br /> CITY OF E�"ERETT LOCAL SALES TAX CODE IS 3105 <br /> i hereby cwiify tl�af I have read and exemined this app'ication and know fhe same to be frue and � �� <br /> conrcL A9 provisions ollaws and ordinances governing fhis typa ol work will be complefed �-i ,'1_;.. ' � <br /> whelher spea6ed herein er not The granting o(a pemut does nof presumo to gi��e authonty to <br /> violateorcancelthe�rovisionso/anyofhersfafeer/ocallewregulatingconsWcfionor}he <br /> perfomiance o/consfrucfion. Thnf I arn aufhonzed by the o�rner o/fhis property to perfonn!he <br /> uark lor�vhich application is made and I compry wifh fhe State Confracfors La�r 18.27 RCl'VanA <br /> 29G.200 VVAC. <br /> � 2 /� � Y ���Z <br /> SignaNre ' � Dale <br /> � <br />