Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � �a0 '"�7 <br /> 425-257-8810 - FAX 425-257-8857 -www everettwa org <br /> c o�08-�6 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� C, I � ��s� � � ��. <br /> PROJECT ADDRESS�s <br /> Lc'_�: r � �.� 1` 661oL Cua , l�� . I_vc�cf� (.,� fl '-�o1S- 35-3- /c�(� <br /> Owne� Mad Addiess � City SIa1eILp P�one <br /> � � v�.c .. �i;c' � _ <br /> Tenanl Ma�lAddrr.ss Cdy Slate2ip P�one <br /> il !� (` L�. Ic � \ f i G .�.�o� S�Sn��C�, 1�1� Vt rnon �ibd7'� J60 yo2 � � ��fi �(� <br /> E�ectrical Contractor Mail Atltlress Crty Slate�Zip Phone <br /> n�� �� <br /> v 6�L L L. � � `� 3 5 K lU ;� ��� � � ..,c 1� r, �e c�c�1 _ <br /> State License Number .� .J Contrad Price of Work <br /> (� �JfLUCGt� <br /> �ll�e �-�,....�..` � Wc'��� <br /> Proposed Use of BuAding Contad Person (Plan Review) <br /> \ r <br /> Descip6onolWorkloBeDone: R�.�!-' � �e O '��1� � �� L1��""'K��� r � �� �C �u2`=��`� Cc�>ilfct,o �5 <br /> � � L <br /> 1 1�liotl `� �v� � v� 1 `� C1( - �Pfc �S L`/�[+ '�' ul �+S �C� ;t�a bY (7��,�c�, n Lis�k'.l".. <br /> 4 II 1 � � ` �otiC fc �.��o-Crincr.� Cil� �� �� �- C✓Y6u, ���h� <br /> � � IS��, Si.µ cncl �L`� 7CI�t� C� �� v - <br /> NOTE WIRING IN NON•^ NELLINGS IS REQUIRE� TO FEE <br /> BE IN RACEWAYb, MC OR AC CABLE <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 <br /> 1 herrby certdy fhaf I Ir�ve rend nnd examined Ihis npplir.��hon nnd knnw fh� snme lo be fnro an�l <br /> concr.l All provrsrnns ollaws anA ortlinnnce�s governrng fhis type o/�vah will be completed <br /> whefher spncdicd heiein nr nol. 7he[�ranhrr,y ol a pennd does not/�resunre fo give aufbonty fo <br /> vinlafe or cancel fire provisions o!any other steM or loct�l law regul.iting consfnicfion or tbe <br /> perfortnnnce olconsWction. Thaf 1 am nuthonzed hy fhe owner ol fhrs properiy fo porfonn fhe <br /> work lor which epplir.nhon is mnde nnd I cornply wAh the Stefe Contrectors Lew 18 27 RCW nnd <br /> 296 2J0 WAC <br /> �\ � <br /> cAtira,.a �.a\C�I�._ $ �lo � <br /> Signetme Dale <br /> E- t-1Gb` • IH � <br />