Laserfiche WebLink
� <br /> EL�CTRICAL PERN'lIT .APPLICATION <br /> CITY OF EVERETT PERMIT S�RVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425�57-8$57 —www.everethva.org <br /> APPLICATIONS ARE AGCEPTED FROM 8 AM TO 4 PM -DE61T&CREUIT CARDS ARE NOT ACCEPTED <br /> 3�0 Z �av�mP.v�� � � ��Vl°�e� �I �ZQ3 <br /> PROJECT ADDRESS <br /> �br��Wi;� Z 7j2� 3 S� ST NLSW LJEr�H�,t/� `�1 �iZ-b3 <br /> Owne� 61ai1 Addr^ss Ciry State2ip Phone <br /> Tenanl Mail Address Cily SlatelZip Phone <br /> N�A ----___ _ __ — <br /> Eleclric I Contractor Mail Addres. Ciry SI.te/Zip Pher.e <br /> State License Number Conlract Price o(Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> DescriplionofWorktoBeDone: /t�-�l� �e 'P�SI S�''n� 2U� �'�P � �0/zyU V�I <br /> ��2 5� d.P�v�.�l'�'t � pCi.v��8( �00 q r � � <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 /> I herety certi(y fhat 1 have read and examincd fhis applicalion ard Fno�v the same fo be fnie and <br /> r,o�rect All provisons of laws and ordinances governing fhis type oI�vork�vill be completed <br /> whefher specdied herein or noL The granting oI a penmt does nof resume fo give authonty lo <br /> violafe or cancel fhe provisions o/any other state or local law m�uPting construc6on or tl:e <br /> perfo�mance o/conslruction. That I am aufhorized by Ihe o�vner oI fhis property to perfomi the <br /> work for which application is made and I cornpty ui(h fhe State Confractors Law 18.27 RCW and � <br /> 296.2��WA�. � <br /> C� �/� � // , /D S / ��� � <br /> Signat e Date � <br /> i � <br /> ✓ <br />