Laserfiche WebLink
� Z — � ?s�— C � <br /> t � <br /> �L.ECTRIC�lL PERMIT APPLIGATION <br /> C{TY OF EV�RETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —Nrww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - G�BIT& rREDIT CARDS ARE NOT ACCEPTED <br /> ��-'�� � �t l,L i fv'1�1�-�l_ l.ii/1�; t,ll.:l! � <br /> PROJECT ADDRESS <br /> i <br /> � y l.C/�l 1 1�)UE�SV'1{� 1'71 � L{�l=l5c�llP_l �1� l,�k E �TEV�t�I�. lt,� �IYj2� <br /> Owne� Mail Address City Stale/Zip Phone <br /> Tenanl Mail Address City Slale2ip Phone <br /> �OSCti [�E�C"tL'�C 1h;C. �iC� Px�X IC�3 �A�.L �TFV1Cti` �Jla "1'�Zr-� 'f-Z5 'J�!'�r�']G.�� <br /> Eleclrical Contraclor Mail Address Ciry 8tale2ip Phone <br /> P>OSCrl��`�'l '��I"� <br /> Slate License Number Coniract Price of Work <br /> c��—�:, <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work lo Be Done: �CG !\l�l P 5C�P V�IL l" <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACE�VAYS, MC OR AC CABLE. � <br /> � 2G� Lii <br /> � <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify Ihat 1 have read and examined this applicafion and know the same to be true and <br /> � '� conect Ail prowsions ollaws and ordinances�overnmg fhis type ol�voik�vi116e cornpleted <br /> il � whetherspecilied herein ornoL The c�ranting o(a pernut does not resnme to give authority to <br /> ;, � violate or cancel lhe provisions of any other sfale or local law reguPting construcfion nr the <br /> . II peAormance ol construction. That 1 am aufhorized by the owner oI this property to perlorm tha <br /> �vork(or which application is made and 1 comply wdh the Sfate Contracfors La�v 18.27 RCW and <br /> i� 296.200 WAC. <br /> ` I� ��,,.,�, �. � , _IJ�?S/[1_ <br /> Signatyre Date <br /> ��/l� -�`��� <br />