Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />4?_5-257-8810 FAX 425-257-8857 — www.everethva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�� I 5E Evr�iT mAu I,�AY µ m`j <br />PROJECT ADDRESS <br />Owner <br />A1ai1 Address <br />City <br />State/Zip <br />Phone <br />�NE�'�inl �Nnr.��At �,2� St EJEt�T�"��nAy ��� nn N E�`e�2Eir �.,F 98�vP, <br />Tenanl Atail Address City SWle2ip Phone <br />(3� S I S i� N St�2v i CrS Vn2I� i'>c7}tFu,-Ev�-'REII N�^/ F�x3 i!r)iu.c �cz�� '�i?7, 33G F31b n <br />Eleclrical Contraclor ntail Address Gly Slate/Zip Phone <br />T s� Si3� � IO�« <br />State License Number <br />�rrl�Ylt�C.lAIJ / SI( !� <br />Proposed Use of Building <br />Description of Work lo Be Done: <br />NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO <br />B[ IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT IOCAL SALES TAX CODE IS 3705 <br />fi�jCJ <br />Conlracl Price of Wurk <br />r-Ra�t� , g +� s i <br />Contact Person (Plan Review) <br />1 hereby certdy Ihaf 1 have read and ezamined Ihis application and kno�.v fhe same fo be Vue and <br />correct AU provisions o/laws and ordinances govermng fhis type o! �vo�k �rilf be canpleted <br />whefher speci�ed herein o� noL The g�anling ol a pemuf does nof presume to give authonty fo <br />violate or cmicel the novisions ol any other stafe or locallaw regulating consfruclion or (he <br />per(ormance ol cons�rucfion. Thaf I am aufhorized by the o�rner o/ fhis �roperty fo peAorm the <br />wo�k lor which application is made and 1 comply with fhe Stafe Cont�actors La�v 1827 RCW and <br />296.200 WAC. <br />FEE <br />50� <br />�l�}0�-0 ��� <br />