Laserfiche WebLink
, <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 !a � a� —� <br /> 425-257-8810 - FAX 425-257-8857 –www.everettwa.org �O cj� Z –/� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> //OC� C�uP>f'r� �T /-'�[�f' <br /> PROJECT ADDRESS <br /> Cl j i lJ1' LJc'n�°f'i �s'O�' rt�l��' � , , ��uPric f i li✓!4 //�S .�SI �f�o <br /> Ownef l Mail Addiess City SlalelZip Phone <br /> TenOnl Mail Address Ciq� SWIeIZip Phone <br /> C, t � o� ���P� T,— T�G.�' �����7r <br /> Geclrical Conirador Mail Address Ciry State2ip Phone <br /> N�=�i,il � 9 ��,� � �So a � <br /> State license Number Contract Price of Work <br /> Sc'�uc'� f.i �i 7 %f. %/O �- /✓�t �J2 /�a, /�ri � <br /> Proposed Usc o(Building Contact Person (Plan Review) <br /> Description ot Work lo Be Done: /� .� S�n �� ( /) n�c,... �� /�p Mo Tu/,' ,..,� <br /> C7�.v i�'� / c' i Pc � �1— <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> DE IN RACEWAYS, MC OR AC CABL[. <br /> CITY OF EVERETT LOCAL SAIES TAX CODE IS 3105 <br /> 1 hereby certity thaf I have read and examined this applicntion and kno�r fhe same fo bo Vue and <br /> conect All pruvisions o(laws and ardinances governmg this ry�pe o/n ork nill be complefed CL,�'�I�- � � [� <br /> whe(her specilied herein or not The granting ol a pernut does not nesmne to�ive�ufhonry to L ��( � <br /> violate or cancel the �rovisions of any other sfafe or local la�r repul.�finc�constniction or the <br /> perlormance oI cons�iuction. That 1 am aufho�ized by(he owner o/this property to peAomi fhe <br /> tvo�k lor ivhich application is made and I compl}��rifh fhe Stafe Confractors Law 18.27 RCW and <br /> 29G.200 WAC. <br /> � -� <br /> � �...� //_� � /.�" .,�� � !%� `i <br /> � -�SignaWre Date <br />