Laserfiche WebLink
( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 g-�6-(D <br /> 425-257-8810 - FAX425-257-8857-www.everettwa.org � �: 'p��,�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ( 'l o i co,,�,�,�_���r�1, A �-L <br /> PROJECT ADDRESS <br /> x�/i.� �'; /%'1����4��.- �!'Ii�� i!i��r�� Di�. Fi�e�"�rf ��l/-; `��Y� cl �' �z5)Y 7c - F'��l <br /> OWner Mail Addross City Slate2lp Phone <br /> Tenan� Mail Address City Stale2ip Pho�o <br /> � �,JJ ; �' <br /> EleclriCal Conlraclor Mail Address City Slale/Zip Phone <br /> Slato Licenso Number Contract Price of Work <br /> � �� <br /> Proposed Use of Building Contact Parson (Plan Reviow) <br /> DescripllonofWorkto�oDona: C���(114 5 'r�tti�h ��' �Ie�S r(� C�!� � !(-'<��/�c�f <br /> �l / � I <br /> L� CDlI/1Pe-� Gt,�G,�� �1 c�-fc�i-' [�tl!/�pS IrrSi�lz l�a�C. <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 hereb}�certify that 1 have read nnd exarnined Ihis application and kno�v the same to be true and <br /> con�cL All provisfons ollaws and ordinancos�oveming fhis type o(worlc will bo completed <br /> �vhetherspecified hemin ornoL The�rantinc�o/a pennd does not prosume fo givo authonty fo <br /> violafe or cancel the provisions oI any other stafe or local law regulafing consfruction or fhe <br /> peAomiance o/constniction. 1 hat 1 am aufhonzed by the mvner o(this properiy to pedomi the <br /> a�o�k lor�vhich applicafion is rnado and 1 cornply�vith tho Sfate Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 1 <br /> �G�'v,t_ ,� �� L'��'(� (���Z��O �' j <br /> j Signature Date ��,� ` �� <br /> ( - � <br /> � � j L <br /> � ., <br />