Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY 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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> Z Z Z � L v �,�..�-r�-' �-v� <br /> PROJECT ADDRESS <br /> l<�tN v;,yr�,J s .� �trr�E_ �ur� z� c� ��,r: s;z �, <br /> Ownef Mail Address Ciry State2ip Phone � <br /> C �,'��ti v r�S S �tt.��� ;;s j< <>' <br /> Tenant Mail Address City State/Zip Phone <br /> ,_L���� c �,- � t�G �i��2 iZC��tur;L'� �( Sr�df'17.�� (,L'r� `�F�(� 2d6'SL(,-�d'Da' <br /> Electrical Cont�actor Mail Address City SWte2ip Phone <br /> p <br /> L L w��c,� � ',u � r�(Z `� 3 v F�El. � <br /> State License Number Contract Price of Work <br /> Yk<ti�t_ c i > -L S� ._. 4� � �, <br /> Proposed Use of Building Contact Person (Plan Review) <br /> � <br /> Description of Work to Be Done: � : .Z , t-r� �' 'r'� S � V �l� — �'�4�0�-+f�T`'� <br /> rll.t�li ✓1 L ( .�!lL'�.1�T�t✓� L. � l�L[ t,ll � ��] 11 i�LC.r�.� 1�` � <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 h,ereby certity that 1 have read and examined fhis application and know the same to be true and r�,�U��G� ` <br /> correcL All provisions of laws and ordinances goveming this type o(�vork�vill be complefed <br /> whether speci�ed he�ein or not. The granting oI a permd does not presume to give authority to <br /> v�olate or cancel the provisions o/any other state or local/aw regu/ating cons Wction or the <br /> per7ormance of construction. 7hat I am authonzed by the owner o(this property to peAorm the <br /> work lor which application is made and I comply with fhe State Contractors Law 78.27 RCW and <br /> 296.200 WAC. <br /> � • � _. <br /> ,��.� /j� , �/��[( j - / L - GJ <br /> Signamre �� Date <br /> `j��� � �, � <br />