Laserfiche WebLink
t <br /> EL�CTIRICA.L PERM�T APPLICATION <br /> �CITY OF EVERET� i�ERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NO'f P.CCEPTED <br /> y �7�� L � c� �v�t�r��Ee v� �:� �,v <br /> PROJECT ADDRESS v � <br /> Owner Mad Address City State/Zip Phone <br /> �� �-��!_= I-Icu;�i �w� �l 7�7 C c. (� Lv�zr�,ry_�_� W��/ Cvz,-� �+ <br /> Tenant Mail Address City State/Zip Phone <br /> ��111�iZC �� ��� �L1CL.��Z� � ��I l � I��lsc�ti��2p �ti�} \lk;��a�l � b� �I��—]`'1 <br /> Electrical Contrac! r Mail Addres� Cfty State2ip Phone <br /> �Y) <br /> 3G�`�US"y�� <br /> �� <br /> State License Number Contract Pnce of Work <br /> Pr�posed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IIJ RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi(y that I have read and exemined this application and know the same to 6e true and <br /> correcL A/l provisions o(laws and ordinances governmg this type ot work wi116e completed <br /> whether spec�fied herein or not The granting of a permit does not�resume to give authonty to <br /> violate or cancel the provisions of any other state or local law regu/ating construction or the <br /> pedormance o/construction. rhat 1 am authonzed by the owner o;[h�s property to pedorm the <br /> �vork/or�vhich application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC.__� <br /> /� / <br /> ,, �� ;_� -- ---_, L;����� J�� <br /> - i51gn31ure' _� Date / <br /> � � � U5C3- vyZ <br />