Laserfiche WebLink
ELECTRICAL PERMIT APPLiCATION <br />CfTY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.evereriwa.org <br />APPLICATiONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />�o`Lo �E �Ve�`Q,k� Iii0.L� �1�.LJ��/o yi ;+% �4�?�C <br />PROJECT ADDRESS <br />A� e�� of� Ct�iv�S i �.l�C, lo� ��vc" r 1xn*l 6'VL�1111��a. =��e ,J i�C �, lq.�Q �S7�f'���ZSi.�ai-'753R� <br />Ownef Mail Address City Stale/Zip Phone <br />l� �� <br />�i [r n� Orl �� r�5 � I,LC <br />Tenant Mail Address Ciry State2ip Phone <br />�c.n���� ��uiic� 2221 ��-Forv�ic�. c��. �.�n.r4�� W1� q$2.DI �425 2S8'-3taS`,S <br />Electncal Cont�aclor Alail Address City Slate2lp Phone <br />�Ol�l l � F�E Z�� f� � <br />State License Number <br />`,'�UY'Q. <br />Proposed Use of Building <br />Description of Work to Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN R4CEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />$ I�1OO . °U <br />Contract Price of Work <br />�I�OL11V4Q oi�1��VY1PiPX' <br />Contac�Review) <br />1 here6y ce�ti(y that 1 have resd and examined this application and know the same to 6e true and <br />correct. A/l provisions ol laws and ordinances governing this type of work will 6e completed <br />whether speci�ed herein or noL The granting o/ a permi; does not presume to give authonty to <br />vio/ate or cancel the provisions of any ofher state or local law regulating construction or the <br />peAormance of consfruction. That 1 am authorized by the owner o( this property to perform the <br />work Por which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />0 <br />FEE <br />�C� ��//— c� 3 i <br />