Laserfiche WebLink
ELECTRICAL PERIV�IT APPLICATION <br /> C17Y OF EVERETT PERMIT SER\/ICES <br /> 3200 CEDAR STREET, EVER[TT, WA 9II201 <br /> 425-257-8810 - FAX42`r257-£3f357—w�vw.everettwa.org <br /> APPLICATIONS ARE ACCEPT[D FROM 8 AM TO 4 PM <br /> ✓ � ia ��PJ' ee � � ._— <br /> PROJECT ADDRESS � <br /> Owner Mau Aadress ciry S�me2ip Pnone <br /> NXr a N � rzM I , ���•F'E �., � � se.i� _ ,�«M c.�_., e�,�l�� ��,� �>��.:; �z�.�7�a�3� <br /> Teaanl MailAddres City Stale2ip Phone <br /> 1'1��,�(L;�,>_ L11. aa3'3 )1����. 5 �lc5 5 aFF� c :4 9f�3 << �53-30�1- 55ns <br /> [Iectrical Contraetor Ma�i nadress Ciy Sfaie2�p Phone <br /> DVl 'II?o�L °l � Io� � Iv�(n. 13 <br /> Stale License Numb¢r Cont�act Ptice of Work <br /> i\C I a i l �%2 r�f ¢ �r�I G� J <br /> Proposed Use of 9uilding CoMact Person (Plan Review) <br /> �escript�on of Wark to Be Done; ��i'h�� h�II�5 1 C�hG',� �U �nerq � ' :ci e n � <br /> n'�e�� IS �"�n I �.c-y�y�rwn� fv�f � �Pe rela� J�'o4fd.vi <br />.� <br /> NO7E: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AG CABLE. <br /> �� ey8 <br /> �I CITY OF EVERETT LOCAL SALES TAX COD@ IS 3105 <br /> I hereby certi(ylh�t 1 have�ad and examined fhis applicallon and know tha samo to be tnie and r' <br /> cor,act. All provisions n/l3ws and ordinancos�oveming fhis type ol work�vilr be.completed U � � � ' (� �- <br /> whefher Specifad horein or noL 7he grantmg of a porm+l doos notp resumo to q�ve authonty to <br /> viclole or cancel the p:�vrslons l any ofhar stafo orloCal law rec�u/ating ccnstruchon or fhe <br /> per/orma ncs of onsWchon. 'hat I am authonzod.Gy fho ownor of fhitn roporty fo porlorm iho <br /> work foYavhich pplication is ade and 1 compty�v�th thc SYatv Contractors La�v 1827 RGW and <br /> 296i20(�WAC <br /> �f /f � -/� <br /> Signa u e Date <br /> 1 <br /> � — <br /> b/c��'btd LSNBLScSchi �°1 6L9ES':99H8 �Nl:woa� ;[ :ZZ TLBZ-ZO-(101�! <br />