Laserfiche WebLink
� <br /> , <br /> � <br /> 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.everetiwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> //�i�� �C:�F��/,.,f� /i 4'.l� l</i�-�/ <br /> PROJECT ADDRESS <br /> ye s= z.sT6-s7�/ <br /> � / /1 � 1 < Y1> i �✓�� .1.-� �>• /.-� C /°//O /rIN.�I 1 Tc O LI vO G�t/T'J Ft� I✓�'1' 9f;]_U� <br /> Owner Mall Address City State/Zip Phone <br /> �/1�"Nl !��""_f"IL��Y<'/Z /�//o r+iuKiL7"Fr�_/�tvp .rur�rl'7`i L-�f1- '�'lFi2u3 [/25=LSTo-S�'/6' <br /> Tenant Mail Address City Slate/Zip Phone <br /> li,v i /'� u= i�r�T✓ � //0/ 1 /S �/h/e �L yM(� 3d3 c'�-z:'YrfT'r..vi- -�'jfyL�b �/zs=3o2-H/.s7 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> C/ (�OU <br /> /"�l! ;,i C v.j 7�1-'lC <br /> State License Number ConGact Price of Work <br /> / i ��. <br /> �l"- �1(.i_ Cr i!-P.���F.fr. i..�l�I1 G y- <br /> Proposed Use of Building Contact Person (Plan Reviaw) <br /> DescriptionofWorklaBeDane: � - � 2tXl 19"�7 �i�U�� L�GrJ% S Q /"�G,S � �`�� �' <br /> r <br /> /f` � /. ../...P '�� � /^/7 '�'( f� '�'_�'li1 L,i� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here6y certify that I have read and examined this application an�know the same to be true and <br /> correct. All provisions of laws and ordinances governmg this type of work wi116e com,p/eted <br /> whether spec��ed herein or not The granting o(a permd does not presume to give authonty;o <br /> viofate or cancel the provisions olany ofher state or/ocallaw regulating crnstruction or the <br /> pedormance o(construcfion. Thaf 1 am authorized 6y the owner o(fh�s propeRy to perform the <br /> work for which application is made and I comp/y wifh the�ate Contractors Law 18.27 RCW and <br /> 296.200 WAC � <br /> ,. /+'�, , <br /> � f ;.�' ,��/ <br /> � .: r �'�/ !/`.. <,f �� rG�� �/ <br /> . "�r. _(;` '%4. '� <br /> Signawre Date <br /> � ��I���_-c�4p <br />