Laserfiche WebLink
ELECTR�CAL PL�RMfT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> I 3200 CEDAR STREET, EVERETT, WA 9,9201 <br /> 425-257-8810 - FAX 425-257-8857 -www.ev�:rettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CkcDIT CARD� AFtE NOT ACCEPTED <br /> �C��.� ���.�AD In�A`� <br /> PROJECT ADDRESS � - <br /> ��!� �' S) <br /> ��,.^`�� '�iV��'_Nl1N11�I�<>S`c�l�;`/" ;C ?`�J 1='�1'�Al �uSn�l C���;flj l.i)A `��"?�� ,-<F�;1- �� ?•r> <br /> Owner - ail Address ity Slate/Zip f�hone <br /> Tenant A.!ail Address City State/Zip Phone <br /> �2�,.�r,��t.., - <br /> EleCtrical ContraCtor Mail AdOress City Statei,:'!p Phone <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> ( i <br /> DescriptionofWorktaBeDone: �= �����2tCoti� C'.�61V1�CZ.iovL .i.=Z, �{:� LOv1Cr.S,i�cvL `�.���r,�.c� • <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE W RACEWAYS, MC OR AC CABLE. <br />, <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> 1 hereby certify th2t/have reai and exammed fhis application and know the same to be frue and <br /> correct All provisicns o/laws and ordinances governing this type of work wdl be completed <br /> whefher speci`ied herein cr not. The granting ol a permd does not presume fo�ive aufhority to <br /> violate or cancel tYe provisions o/any other state or local!aw regu/ating conshuctwn or the <br /> peAormance o/con.strucUon. That/am authorized by the owner of this property to pe�;orm fhe <br /> work/or which application is made and I comply with the Slate Contractors Law;&.27 nC�V and <br /> 296.209-kV �� <br /> \ ���� �/ /' <br /> n �-,�w,, � I'l 7 �� "L� <br /> �__c';•_,. <br /> �� <br /> Signature -- �ate � <br /> �����- (�� <br />