Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <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 S AM TO 4 PM <br /> ;,' -� ?i -'� �1,� , ;��- - <br /> PROJECTADDRESS - <br /> �� Jl ,� 1�,�� � �zo ��� 12'1,���� � 11� ct �� ��;�; ��.�:_ � <br /> Owner <br /> Mall Address Ciry State/Zip Phone <br /> '� rr�ti itr c l �1 i ZF 2L� �pKE' HYC J1/ei�E' H Ct >J� �.`:ZL'J �>C`� 3i'��'��rti( <br /> ��� Slale2ip Phone <br /> Tenant Mail Address Y <br /> t ertqnf W (�Y <br /> 1 �1 \ � �� C A/[� �'(rvei�S / )�� c/[�Zl; ,`>� L'Q�-+ ZISJ'Y."'. <br /> N� 1 i 1 ♦�, �C1`�c i .Zy vY � U � Phone <br /> ElectricalContractor MailAddress Cny SlaterZip <br /> ��_�ia;2 J:* `.�'�"?. L— ?- �'�LX'� <br /> State License Number Contract Price of Work <br /> ��}�� � �� � Y�kS��e Contact Person (Plan Review) <br /> Proposed Use of Building <br /> GC-;C� <br /> Square Footage(If residentiel�ew construction,remodel or addition) <br /> Description of Work lo Be Done: /� �i �/ � �� /'T�� N< ' K-(c C /'rc�r� 't ze/e � /�/�'��� ' <br /> n f /Yl'r )>T � � -Ea tt�ICtCTf'it� ful�l� exT�i/� ?yt�✓ C�,/'c'v�� �'u CSra`fccc, � <br /> , . � r (/ J`-�. i/�`1�•�� �'r�'/�/��fC�/" ��1��( �i�t— ��_ <br /> ` �/. /�f�� i ",y `�i ,e ("C�/�.°:C�ci . � __ <br /> NOTE: WIRING IN NON-DWELLINGS IS RE(:UIRED TO FEE <br /> � BE IN RACEWAYS, MC OR AC CABLE. i� <br /> ( 32�._ <br /> CITY OF EVERETT LOCAlSALES TAX CODE IS 3105 <br /> I hereby ce�tily(hat 1 have read and examined lhis applicafion and Wiow Ihe samo to be tn�e and r I� I-�2 _r1O ("� <br /> con�ect. All provisions oJlaws and ordrnanees govemmg tlus typo oI woric will be completed k V J �J-� v <br /> ,���r.fher spenfied he2in ornoL Tho gran6ng ol a pemuf does not presumQ fo givc aidhority to <br /> violaFa orcancel the I�rovisions ol any oNer sfute or local law regulafmg consLuchon or fho <br /> pedonnance of consfruchon. That 1 am aufhonzed by!he o�vner ol tlus property to pe�fonn the <br /> �vork(or which applicafion is made and 1 comply wilb tho State Contracfors Law 18.27 RCW and <br /> 296.200 WAC•. ` j <br /> �r^ 4 �- / � � <br /> I�.�__"J_k_��.1 �_.. �.�% /:✓�� Z�� �_) <br /> �`. <br /> � Signature � Date <br /> I —-- — — --- -- -- <br />