Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> GITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 95201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED PROM 8 AM TO 4 PM <br /> 71171 �P.P,Mr.�eR /1oAcC � �`K y�-�� <br /> PROJECT ADDRESS <br /> 2)�% <br /> Owoer Mail Address City SUte2ip Phone <br /> tlJl� l �/t . <br /> Tenant Mau Address City StatelZip Phone <br /> �1 s.s��Th�.Q E"l ��. �a B�x Z a�� -Sw�4�..n� � .�A- SP��i ��- 3J���� � <br /> Electrical ContraCtor Mail Adtlress City State2ip Phone <br /> 745� aC,CL b �3�rrt.._ ��" "'"" <br /> State License Number Co ra P ice of Work <br /> 1,rC �h �',�,,�.�,�.e.k.( <br /> Propodsed Use of Building Contact Person (Plan Review) <br /> �' C� 7 c1.�.�f�y� ,j—��t-41� /cJt � <br /> Description of Work to Be Done: .� NS �u - -L - <br /> 1 / �]l'v/VcI�C� ' Z' 2 `.."`.. /EH/1 1✓4�'a.�S ' 7' �tl•�t� �C/""2i7d,fr <br /> �— � a53�C -.,n �J•��C .t'����1.�lh <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> ICITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i rereby certily that/have read and examined this application and know the same to be true and <br /> �onecf. All prcvisions o(laws and ordinances governinq this type of work will be eompleted <br /> whether speafied herein or not. The granting of a permit does not presume to give authonty to <br /> violate or cancel the provisions of any other state or local law regulatin�construction or the <br /> peAormance o(construchon. That I am authorized by the owner of this propeRy to peAorm the <br /> work Ior which application is made and I comply with the State Contractars Law 18.27 RC W and <br /> 296.200 WAC. <br /> ��%rC� � �� ���///c?� <br /> Signature Da � <br /> �G(ola — (�5 �� <br />