Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE-fT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —�rvw.cverettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � -� <br /> � � Z�� �YOci C�U-��_ <br /> PROJECT ADDRESS <br /> L:,,c� �,��,.�— <br /> OwnCt Mail Address Cily Slale2ip Phone <br /> 57 �'�: �YocJ',WiWI �-e�✓R.n'Ifi �.!/��} 7 ��2, <br /> Tenanl M il Address City State/Zip Phone <br /> LvL1s�T.e (,� �% �� �S�d � Fr�y 99 ,q c ,��l�a�� w� ���� <br /> EledfiCal ContrBclor h7ail Address City �ale2ip Phone <br /> Lt�u�7�uL 933 (��' # � — <br /> State Licens=Number Cont acl Pnce of Work <br /> �'Y M Y '''^.'Ul <br /> —� , <br /> Proposed Uso of Building Conlact Person (Plan Review) <br /> Description of Work lo Be Done: Gb7'JhP` I -t� �i�^ L" '7�` "� <br /> �b eX 6..� S��� �2 ��lnF_ In,��-- <br /> NOTE: WIRING IN NON-DWELLINGS IS R[�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLF. <br /> CITY OF EVCRETT LOCAL SALES TAX CODE IS 3105 <br /> 1 heraby r.eriAy fhat I have read and examined this applicafion and kno�v Ihe same lo be frue and <br /> correcL All p�owsions ollaws and ordinances govemin�this type ol work will be completed <br /> �vhefher speci6ed herein or not 7he granling u/a pemut does nc; �resurne fo give authont}�to <br /> �iolate or cancel ihe provisions oJ any ofher sfate or local law regulafing consfruchon or the <br /> po�fonnance olconslruction. That I am authorized by the owner o/this property fo perfomi the <br /> v;ork lor whiGi applicafion is made and 1 comply with Ihe State Confractors Law 18.27 RCW and <br /> �96.200 WAC. <br /> _ ��'��b ' k� �� �,, �� � <br /> Signature � le <br /> ,���o � �.y�j <br />