Laserfiche WebLink
OCT-13-2011 14:28 From:LNP 8886159679 To:14252578857 Pa9e:1�2 <br /> C. A. <br /> �LE�TRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR Sl'REET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—vuww.everetlwe.org <br /> APPLICATIONS ARE ACCEPTED FROM 9 AM TO 4 PM !D"�3 r�f <br /> 0 <br /> � t7 u►o --0 2( <br /> 5 1 G,.�� ss�r � �,3 E,k,e�� u� <br /> p�tOJECT ADDRE S <br /> Owner Mail Addresa City StelelLip Phone <br /> ����;� -.� t�s c� Fa;1�4� 53.�1 E'.�rn�rcvn � E�}I- wA �s�ao� ya5=��'t <br /> Tenant Meil Addres city Stete2ip anone <br /> n�.G.� Ele��-� � tl� ���z �¢ A�. S. ��LS �a�h� i.�t} 9�13`l a5�-Sc,:�-SSoS <br /> EleGrical ConVactor Mail Addiess City Siater[ip Phone <br /> �v1E7R�F� � � I r�� a i �c�� . 5 3 <br /> State Lfcense Number Contred Price of Work <br /> �Jln�'t5ale � ace ha � � fc�Uc�i �LS� �,w.v.�co�S <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Woric to Be Done: �.,,.., arot �I la s f C r�c� � e�w r�,,, eTY�ti e✓� � <br /> 1�c�r�.� ���n n ��„ l ✓Y��'Y�t..v.l Y'� �[ , +�fi�. C.�� _ <br /> J <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 3�05 � ��� � <br /> I here6y cerNly that I have read and exam(ned this applica6on and know ihe same to be Lue and 1 <br /> correct. All piovisions oflaws and ordinances goveming this type o/work will be comp/eted C V� �l�— � I <br /> whelher spec�fied herein or not. The grantlng ofa perm�f does nat presurtie to give authority to <br /> vialafe or cancel the provlsions of any otherstafe oNocal law regulat�qg c�nshVctiOn orthe � <br /> peAoimance ot consWqfion. That 1 am authanzed 6y the owne�of thisP roperty to pe�Iorm fAe <br /> work for whiyh applica n is made and I comply with�he Sfate Conhacrors Law 18.27 RCW ana <br /> 29B.200 WAC. <br /> 1 <br /> i � <br /> �i /c-1� -1/ <br /> Signature oate <br />