Laserfiche WebLink
ELECTRICAL <br /> PERMtT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR S'i REET, EVERETT, WA 98201 r! � � 3 �C� <br /> 425-757-8810 - FAX 425-257-8857 -www.everettwa.org l q <br /> APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � �IO/D��� <br /> � I <br /> / <br /> � �1 3��� w���i"�cASi�� � �'�5��/������"s� <br /> P OJECT ADDRESS � <br /> Owner Mail Address cdy s�ate2iP Phone <br /> Ten2n� Mail Address Cdy Slale2ip Phone <br /> � Fl���t�lC ��• ��C'1�°� �1�VI�C� lo�l� �7� '.�0—� �� <br /> Eloctrical Conlractor M17ail AJdress c�ry S�aic2�p Phone <br /> . ' ,��'� � ' ( � � � ��� <br /> Sl�te Lir,onsr.Number Contrac�Price o�Work <br /> S��l� c��L� <br /> Pmposed Usc o( �uilAinn Contact Person (P�an Review) <br /> Descriplion of Work to Bc L'onr,: ( l�t�—�I�l'h ��'��"/`— !!/ �/`—��� K'-' Y�//��y/" � <br /> _ �- a��� 1� ��,�� _� � -,�v�a� -�ti�,�1,�� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FCE <br /> BE I�J RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I h��eby c�rrtAy fhat 1 havrz rond and��xanunod Ihls epplicatian anA know fho 5nme fu Ge true nnd <br /> ronncf All provisons ol laws and o�i/uiances{�ovemmg fhis type ol wo�k will be completed <br /> �rh�thc�spoalied hr,rcin cr nof. Thc nranfmr�ol a pennrf does nof resume to give auL�onfy to <br /> violafe or ct+ncel fhe`vovisions o/any ofher sfale or local law reguPting consfruc(ion or fhe <br /> perforrnance ol construc6on Thal I am�ufhorizPd by fhe owner o/fhis property fo perlorm(he <br /> work /orT'hich app6cafiorr is rnraJc and 1 comply�ti�ith fhc Sfafe� Confraclors Law 18.27 RCW and <br /> aec aa�wac. �� <br /> . <br /> i � <br /> �,`Zc.%���`��.�' ---- - — - <br /> Signalure Dalc <br /> CUSU�I-Gy6 <br /> i_._._ -- — - - — ---- <br />