Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />ClTY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SJa�I Y,� �c� t�►�� <br />PROJECT ADDRESS <br />V <br />Owncr <br />Tenanl <br />Mail Address <br />Mail Address <br />s. <br />City <br />Cily <br />��e �r <br />v�7�8�-�y� <br />� w.� 9��43 <br />Slate/Zip Phone <br />�/o�ti-�y7-�; <br />tsp <br />Slate/Zip Phone <br />[ / �.�% l7 ii! <br />Eleclrical Contraclor Mail Address City Stale/Zip Phone <br />Stale License�� r <br />�ff�✓oi�� $r/i�l� FC'irr�ilV �'10/YIP_ <br />Proposed Use of Building <br />Description of Work to Be Done: � d'"''^'��'� O£ �C�,'�'G�C�'1 <br />(JOTE: WIRING IN NON-DWELLINGS IS REQUIREJ TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />C!TY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contract Price of Work <br />Conlact Person (Plan Re��iew) <br />! hereby ceriily fhat I have read and examined this applicalion and kno�v fhe same to be frue und <br />cerrecf. All provisions o//aws and ordinnnces governing this type ol�vork will be complefed <br />�vhefher specdied herein or nof. The �ranfinc� oI a pemut does nof resume fo give authonry to <br />violate or cancel the Provisions of any olher state or local law reguPting consfrucfwn or fhe <br />peAormance olcons,ruction. That 1 am aufhorized by fhe owner ol this property to peifom� fhe <br />work (or �vhich applicafion is made aJ�AI compty �vilh fhe Sfafe Confracfors Law 18.27 RCW and <br />296.200 WAC. / / <br />FEE <br />���-1\C�-�2y <br />� <br />