Laserfiche WebLink
( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32U0 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.evereltwa.org �_�3_�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM / �3D 3 _�( l <br /> l:. <br /> '� � � � �� �i��� ' � '�� � �i � !� 71 >R . � <br /> PROJECT ADDRESS <br /> � <br /> i1 � 1 `ti G / <br /> �_� �� (�� � - � � iL� ,` , � � A � � �� i��L� tiL ��.i;.,��5. �/i ��v%, �ldt-� ' S�'- i: <br /> Owne� r Mail Address Gty Slate2ip Phone <br /> � <br /> Tenant Mail�ddiess Ciry StatelZip P�one <br /> � � <br /> (�fi> > ��,1� � �� V�r�e�; � <br /> Electrical Co�trador Mail T�laresc Ciry State2ip Pnone <br /> � 4'c� <br /> State License Number Conlrad Price o1 Work <br /> �� �5�-- Conlad Person (Plan Review) <br /> Proposed Use of Building <br /> �7��S � <br /> Square Footage(It residential new construchon, remodel or addiUon) <br /> Descriptlon of Work to Be Done� _� 1[��,�, l� i' ��:: t�_ . �� � ,' + ",. �. • S _ <br /> NOTE WIRING IN NON-DWELLINGS IS REOUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE . ���1,1 <br /> ✓ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> 1 haroby coridy fhat I Iravo reaA ar.d oxarmned fhis applicafron nnd know fhe samo to be Inm and -� •.. 7 /� � ,i <br /> correct. All provisions ollaws and orAinances qovernrng fhis fypo oI work wdl bo complofed � I �(_i ) � l :' ��-`��� <br /> who(hor spoci/rod hnrein o�noL Tho granfmg ol a pemnl does nof resmne fo givo nuthonty to � <br /> violafo or cancol Ure provrsions o/any olhor slafe or local law mgu ahng consfn�ctron or the <br /> i <br /> perfonnanr.e o!conshuchon. That 1 am aufhonzod Ay fhe owner ol flris proporty fo pedorm Ilro <br /> work lor whir,h applicahon rs made anA 1 comply w/fh fho Sfale Conlroctors Law 18.27 RCW arrd <br /> 296 200 WAC. � ,_ .� / <br /> � � . �' <br /> I .� � �.)�i���� �) � i .; .. <br /> i � <br /> �nati / :_� Date <br /> ______ ... ____ .' _ _..____..__ _—_.—_ —_ i <br />