Laserfiche WebLink
• • <br /> ELECTRICAL PERM�T APPLICATION <br /> CITY OF EVERETT PEkMIT SERVICES �`�6�a <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425257-8810 - FAX 425-257-8857—www.everetlwa.org �/G�)—C7(� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 7fo IS I�es� �'i,�S iNn ��ar,�, �l�e.,rr_� l/11� �l g�� <br /> PROJECT ADDRESS 1 <br /> S n] �(,�,,,i�- llZl SU7 SrL►,�,.� s� �r��a►vJ� � �- �'�-?1JS <br /> Owner Mail Address City SlatelZip Phone <br /> YyNIP1.J'�) 1.P�N 5� t.��s �S�- �iCiM Gl. Fi�b/�ryY- Wl� —lO�y <br /> Tenan Mail Mdress GIy StnlelLp Phone <br /> � �lu�r� � �0, �3e�� �32 �«,m�(�u,�� LL� q8oZ2 (3,6082S=�o90 <br /> Elr,cirical Contractor MaA Address Cdy Slate/Lp Phone <br /> ��C��cl2sl�2 0 <br /> State license Numh�i Contract nce of Work <br /> .�/1� c� S�JU.� a ��L—�V��(�'�)�y'D—aSB� <br /> Proposed Use ol DwlAmy Contact Person (Plan Review) <br /> n � rL / <br /> Description oi Work to Fie Done li" I NCi � C-\ r Ll� 1 1 � � l��G0...�\1V Q <br /> �' Lic ��-s <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 9105 I � v <br /> I hereby certdy that I have ieaJ and e�ammad thrs app7r�afron anJ Anoiti the samo N be froe and <br /> correcl All provrsions ollaws and orAinances govemmg fh�s type o/work wdl be completeA <br /> whether spec�6ed herern or not Tbe granhng ot a permd does not presume fo grve acfhonty to <br /> vm�afr, oi cancel Ih proasron I any iar sfate o�locel law regu/aGnq consfruchon or fhe / �, <br /> peA nran r, o!c stn�c6on TI f I a uthon:od by fhe owner ol fhis property fo perfomi fhe , �(�t��� <br /> wnr or w rch a �caf�on�s ia e an 1 �nmply with fhe Sfafe Confrar,fnrs l aw 1H 27 RCW antl �"� <br /> 296 00 AC. � �� � <br /> Q� <br /> Siynature ale <br />