Laserfiche WebLink
� <br /> ELE�T?ICAL p�RMIT APPLICATiON <br /> CITY OF EVERETT PERMI�' SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARC ACCEPTED FROM 8 AM TO 4 PM <br /> � �'f�/ f�Zt2� it'�..�I "`�ity CJP�h�� li(l�i �j�,�{�� <br /> PROJECT ADDRESS <br /> Ownor Mall Address Ciry Slate2ip phone <br /> —SM1`t�GQ /C'iiUGr/�rn � �la (( c.��cy ��C�/`c�j,t Lci�t �J�P.�t;�4' 7�Q �P�L/ <br /> Tenant Mall Addross Gty Stale2lp Phono <br /> ��'rr�f 1�Pv,1 ; yoc� f�i��cQNS •t 131 r°`c:`e �" ��ic yp��3 YI; �7$� 5-- <br /> Elec[rical ont�actor Mall Address City State/Zip Phone <br /> �%f f 4 �C,(� '�7 � M l? l (7/'l °'-�–' - <br /> Slate Licen Number Contract Price of Work <br /> C� ��,�� _rc�..� N��t,�- P<«�l l.�«,,�. <br /> Proposed Use of Building Contact Person'(Plan Review) <br /> DescdptionofWorktoBeDone: �"IbnlL 6�(J Pc'>�-�'� io 5�,4�i T/�.z� �3• �c• Ec <br /> � <br /> � ��S'f'u ll�•�Q <br /> II NOTE: WIRING IN NON-DWELLINGS IS RE(1U�RED TO FEE —' <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODc IS 3105 <br /> 1 hereby certily thaf 1 have read and examined Ihis application and know the same to 6e true and <br /> correcL All provisions ollaws and ord/nances goveming this typa ol work will be completed <br /> whether specified herein or not The granting of a perm�t doas notprosume to give authorily fo <br /> viola(e or canc.el the�rovlsions o(any other state or locallaw repulating construcfion or the <br /> performance o�construcfion. That 1 am authorized 6y the ownerof ih7s�roperty fo peAorm the <br /> work/or whlch application is made and 1 comply with the Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � , �_ i <br /> -���„�� �;, � ;� 3��� � <br /> r <br /> Signalure .�Dale T <br /> � <br /> �aGoG -U�� <br />