Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982�1 �� �a9.� g <br /> 425-257-8810 - FAX 425-257-8857 —www.everet�wa.ory �D��Z,�S� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> l�l �f C�i��47`"-r,.� 7` (* ,/.�� vrj7`P �i• �'� <br /> PROJECTADDRESS <br /> l/��� �-r��,o r /��-r.�r I`� �/�S 3�/y y�7 <br /> OWner � � MailAAdress Cily Stale2ip Phone <br /> /`�� <br /> Tenant Mail Address Gty Statc2ip Phonc <br /> �jG..11 (r✓ 7ti ST�Y� ��i�-5 � <br /> C�,sTo,.,_T�� H ,�'/��Ti � 4.��r STP,�r,,s �t� 9�.�tsfl ��93 <br /> Eleclrir.al Conlrar,lor hlail Addmss City Slatc2ip Phone <br /> <<.,s7�- � > � c- ,f T �s �� <br /> Slate Lir,r.nsr.Number Contract Price ol Work <br /> —! , � �r, v r df � -4�ir_ � �i.�.7 f��1 <br /> Proposed Usc ol�uilding Conlacl Person (Plan Review) <br /> Descriplion o(Work lo De Done: ��P�i � ,1��?j // C7� 7�, 7 <br /> NOTE WIRING IN NON-DWELLINGS IS REQUIR[D TO FEE <br /> DE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 herc�by corllly fh;if I h�ve rend and r.rnrnined fhis npp6c��lion and know fhe same fo be fn�e and <br /> conecL All pio��isions ol/a�vs and oidm�inces c�overning fhis fypo ol�voik wdl be complefed <br /> whi�ther speahrd hen�in oi rroL The��antinc�ol a perrnR Aocs not presume fo give au(ho�ily(o <br /> violate n� canrol fhe`�rovisions ol eny ofher stafe ar local law ier�ulafing consfrucfion or fhe <br /> perlo�mancr o!cunsf�ucho, Thnf I�i:n nuflto�izeAby the owner o/Ihis property fo perlorm fhe <br /> worF loi which:ipplicafion is made anA 1 corn�'y �vifh thc Sfnfe Confracfors Law 18 27 RCW and <br /> 296.200 WAC. <br /> �.__fh__ � <br /> , � � ���� / <br /> y�Jr ��L � 7! < -�� l Jt � <br /> Signaturc D le � <br /> �j��- I <br />