Laserfiche WebLink
ELECTRICAL PERMIT �+►PPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR :�TREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.evereitwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� ZZ`l �a:v� /n� '�,- <br />PROJECT ADDRESS <br />..,vzln- <br />Owner <br />Tenant <br />��c.�t�ui f�«;,2,`, <br />Electrical Conlraclor <br />License Number <br />Proposed Use o( 6uilding <br />Description of Work to Be Done: <br />Aiail Address <br />Mail Address <br />A1ail Address <br />NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Ci�y <br />City <br />Cily <br />staic 2ip <br />StatelZip <br />Stale/Zip <br />3 _ a- 3-� ,6 <br />c=o E,o 3 .-i a `1 <br />Contracl Price of Work <br />Conlact Peron (Plan Review) <br />1 here6y certil}� thaf I have read and examined fhis applicafion and know Ihe same to be tnie and <br />correct. All provisions o(laws and ordinances govermng this type oI wo�k �vill6e complefed <br />whethe� specdied herein or noL The granfing o/ a pemuf does not resunte to gii�e aidhordy fo <br />violate or cancel the provisions of any ofher sfafe or local law reguPtinc� construcfion or fhe <br />perlormance o(conslniction. That 1 am aufhorized by Ihe ou�ner ol fhis property fo peiform fhe <br />work Ior which applicalion is made and I compty with the State Contracfors Law 18.27 RCW and <br />296.200 WAC.1 <br />�. <br />FEE <br />. <br />� -��/�� <br />�� b> <br />Phone <br />19TTii? <br />Phone <br />