Laserfiche WebLink
1 l <br /> ELECTRICAL PERMIT APPL�CATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM G -1H -0 8 <br /> ` s o$o4-��i <br /> �2�� W i_.����IfeU �OqC.) ":tti�.l.�� �iLP..: <br /> PROJECT ADDRESS <br /> lx>E�ti�; �,n.��,�,tiy P��. i_xvc Slvl MS 1 �ei-� ��c.�i�t UJH. 9r��:-�_ <br /> Owner Mail Adtlrcas Ciy StatelZip Phone <br /> Tenant Meil AdAress Ci�y Slale2lp Phona <br /> 7�Y� <br /> 1'U S.�C;���i���Gl� C:.a-an��_ �4��� IJL-� fi'�J,� J�. f� � �� �C1�Till� W�� iFlil ��3,'61[�l1 <br /> Electrical Conlraclor Mall Address City Stele2ip Phone <br /> 0.� <br /> �=oV ln,�cc,1�>--N � JO,GL1> <br /> State License Number , Contract Price of Work <br /> Proposed Use of Building Contacl Per,on (Plan Review) <br /> � � <br /> Description af Work to Be Dane�. r��= i 1 f�c��r� i�Mc?�-•L ��' i=o�. �_�� <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED �O FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> '> Sc`� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS�105 <br /> I hereby certJy that 1 Fave read and exumin;d this app�icafion and know the same to be true and <br /> corroct Ali prowsions ollaws and ordinancas govarnmg fhis type ol work will be Compleled <br /> whether speciliod herein or noL The granfi�ig o/a permrt does not presume to give autbonty fo <br /> violate or cancel the provisions ol any othei sfate or local law ragalating consfruchon or the <br /> perloimance o/consfrucfiort That I am a�dhonaed by the owner o/flris property fo peAorm fhe <br /> work lor�vhich application is made and I comply with the Sfate Contractors Lew 18.27 RCW and <br /> 296 20U;VA C. <br /> , ;� �p� ,��. <br /> ,�> ;- �—l;<'_�I�,;; <br /> // qnaWre ' ate <br />