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.everetriva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> 5 7 z G� d3 �'o�D W r�`� ��'�:_ #�C�'> <br /> PROJECT ADDRESS <br /> (aNH�' r P�UG�d�HE�� y i� <br /> 372�, g�o�p��; EV£,eET� t,lr� q Y261 3 �7-6160 <br /> Owne� Mail Address City State2ip Phcce <br /> MO��UT'11N 37i�. 3RurL�wA� <br /> �✓�cIFIL �/+l'K �3 � E✓E2�i i L✓N `f �i01 <br /> Tenant Mail Atldress City State.4lp Phone <br /> G-� 5 1'1 E��r��tJU. . s o� 3 c.<, <br /> � coo�i�icr EAs� Mwi�u S i hda��E b„ � ti 6�.72 �yy—� scr, I <br /> Electrical Contractor MailAadress City State2ip Fhcqe� I <br /> GS ► i.�►}crnc�� � 5 � � z� �;` `�� <br /> State License Number Con:ract Price of�Tprk • • <br /> � <br /> 1_G H h�(��I Y-�L �v IV H�)I,h��" P_,.�, t <br /> Proposed Use of Building Ccntzct Person (Flan ReJiev,) <br /> yZs-7s�+ �367 ` <br /> Cescription of Work to Be Done: �v r`t n.J E"� T ( 3 � T S I' /}—T 5 I <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN R,4CEWAYS, MC OR AC CABLE. � <br /> // <br /> � l; <br /> i CITY OF EVERETT LOCAL SAlES TAX CODE IS 3105 <br /> I hereby ceRify,hat 1 have read and examined fhis aFP�ication ar,d Kr,cw the same to be true and <br /> cerrect All prcvisions of laws ar,d crdinances gevemir,g Lhi;type ol work w;ll be ccmpleted <br /> wFether specihed herein or ncf. The granting cl a permrt dces nct presume fo give aulhcrity fo � <br /> rio/ate or cance/the prcvisions cf any oth,er sfate crlecal law regulafing ccnstruc5on cr the � <br /> perlcrmance e/ccnstructrcn. Th,at 1 am authorized by the cwner of;his prcpeRy to peAorm the <br /> wcrk!cr which appliwticn is made and 1 comp/y with the State Centractcrs Law ;6.27 RCW and <br /> 296.2G0 WAC. r) <br /> 2~V <br /> 'S��_ � I � � <br /> .,,'^, ��r..,..,,,,��,1J,--, /i- L `— v �7 �� � <br /> - Signature Date I / <br /> V <br />