Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES ��_9_oy <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �/ !/ <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org E� '/ �� ' ��j <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> �8 D t3 ���A��� �I v�� �%���=�, C=7T <br /> PROJECT ADDRESS <br /> /t���- <br /> �_ �r���; �l�r� !� T����k ��� yr�,u.� ����c (Mq �z7 S <br /> Owne� Mail Address City State/Zip Phone <br /> l/2S•.3S�i'- l�n7 � <br /> Tenant Mail Address City Slate2ip Phone <br /> Electrical Contractor Mail Address City Slale2ip Phone <br /> Slale License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (F�an Review) <br /> Descriplion of Work to Be Done: <br /> NOTE: W IRING IN NON-DW ELLINGS IS REDUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi(y that I have read and examined fhis application and know the same to be true and <br /> correct. A/l provisions ollaws and ordinances governmg th�s type o/work�vill6e completed �`1(� I I ,,` ' <br /> whether speci(ed herein or not The granfrng ol a permd does not presume to give authonty to t L1�f y <br /> violafe or c�roel fhe provisions qf any other state or local law regulating construcfion or tbe <br /> peAormartce of construc6on. y/�at I am authonzed by the owner o(th�s property to peAorm the <br /> work for�vhicl�applic�ion i;,rfiade and 1 cornpty wifh the State Contractors Law 78.27 RCW and <br /> 296.2001yAC. � <br /> <`tX�'-�� , �(/-" (/ /-� // � J . U� <br /> Signature �� ) Date ' <br /> � <br />