Laserfiche WebLink
F_LECTRICAL PERMIT APPI...IGATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 42�-257-8810 - FAX 425-257-8857 —www.everettwa.orc� <br /> AHPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE IJOT aCCEPTED <br /> � � � s LSruRL�( Wu'� Ste � <br /> PROJE�T ADDRESS <br /> Owner A1ail Address City StatelZip Phone <br /> � � I��r�, c:� u�cy �� N «-� <br /> Tenant Mail Address City State/Zip Phone <br /> ���47_ ��[�C t��• C' ���� �SUX �� � 4� L,�/lvlWnc��/ W(i � i�i��i V' �}.Z.S-[�{G 3`1.S'3 <br /> Electrical ContraclOr Mail Address Ciry State2ip Phone <br /> � c�i z �� �:�� �i '7:� .�i> -$�9r��; .�� <br /> State License Number Contract Price of Work <br /> . <br /> Lo m�n s;�C, �, _ <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: �- �9 S�G I� 1�,�(/✓u (_-a r�c.p�i� a �'e`� (` k rS �Dr �'✓�n l _ <br /> J�C S tC�_�u �Gal-� ��:t�S � �'L�`����Gl il?4liG 1-�s�s /7 e-ti /�_�IA C ���� C � � {C�/ — <br /> � rP;.:, �� �-Y �}� � Ii�� f(.I /1 / •f4.E L°I/'.�1Ic ��OT S ( �i /� . <br /> � — <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certity that 1 have read and examined lhis application and know the same to be true and <br /> conecL All p�ovisicns oi/aws and ordinances goveming fhis type of work�vill be completed <br /> whether specdied herein or ncL The granting o/a permd does nef presume to give authonty to <br /> wolate or cancel the provisicns of any other state or local law regu/ating construUion or the <br /> performance ot construction. That I am authonzed by the owner o!this propeRy to peAorm the <br /> work for which applicaticn is made and 1 cemply with the S!ate Ccntraclors Law 18.�i .4CW and <br /> 296.200�Wq6. <br /> / ,,; <br /> /�! <br /> �/�'� o(rt:� <. �- <br /> ' Sig aWre Date <br /> �dqlf' I '�q � <br /> I <br />