Laserfiche WebLink
ELECTRICAL PERMIT APPLICi4TION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — �nnvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM ti AM TO 4 PM <br />� �-� � I=Pd��G I ,�IvP <br />PROJECT ADDRESS <br />Ocmer <br />Tenant <br />Electrical Contractor <br />Mail Address <br />Mail Address <br />(otizl 9"pc �f <br />Mail Address <br />l�I� �' �FI � S Z C�1 G <br />State License Number <br />Proposed Use o( Building <br />Description of Work ta Be Done: W i/ <br />2G'G C�/G�,�' S�/'v�� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RAC[WAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />City <br />City <br />Stale2ip <br />Slate/Zip <br />State/Zip <br />Contract Price of Work <br />Conlact Person (Plan Review) <br />��T <br />1 bereby certily that I have read and examined this application and know the same to be true and <br />correct. All provisions ollaws and ordinances �overnmg this type ol work will be complefed <br />whether spealied herein or noL Tl.e granting o/a permd does not �resume to give authonty to <br />violafe or cancel the provisions o/ any olher state or local law regulating construction or the <br />performance o( construction. That 1 am authorized by fhe o�vner ol this property to per/orm the <br />work Ior which app/ication is made and I comp/y with the State Contractors Law 18.27 RCW and <br />296.200 WAC. ___ . _ <br />-_ ' — <br />� —,: <br />- c'_ �/ �' <br />Phone <br />Phone <br />Phone <br />e <br />FEE <br />� <br />�Dy���J� <br />1 <br />