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 & CRCDIT CARDS ARE NOT ACCEFTED <br />9� � 5 � � ,.r"��erP�T �� �, .5�c,��e ,� Ssc� <br />PROJECT ADDRESS <br />Owner <br />re�a��� <br />�1 <br />Elect�icaT o� <br />Address <br />Mail Address <br />Mail Address <br />-ao �� �sa�o <br />City <br />v r, <br />Cily <br />� . <br />ary <br />' 1� � � ��.L �i (�, f� .L C�, <br />Stale License Number <br />���� <br />Proposed Use of Building <br />Description of Work lo Be Done: �L" <br />NOTE: WIf21NG IN NON-DWELLINGS IS REQUIRED TO <br />BE !N RACEWAYS, MC OR AC CABLE. <br />CITY OF EVf RETT LOCAL SALES TAX CODE IS 3105 <br />StatelZip <br />SWIe/Zip <br />��.�- ySS-l9s <br />i,���J <br />Phone <br />� Phone �6 � <br />2Z__ ��' �d <br />�'N �C�- <br />Conlract Price of Work � <br />� /1 I' <br />-_� � �'` �� <br />Contact P on (Plan Review) <br />aoc�-�76-37s'� <br />1 hereby certil ✓ thaf 1 have read and examined this application and kno�v the same to 6e true and <br />correcL All pi?visions of laws and ordinances govenung Ihis fype o( work will be completed <br />�vbether spea,ied herein or nof. The granting ol a pennd does not resume fo give authordy to <br />violate or cancel fhe provisions of any other state or local law reguPfing construdwn or fhe <br />pe�formance o/ construction. That 1 am authorized by Ihe owner o( fhis property fo pedonn the <br />�verk lor which application is made anAl comply wilh Ihe State Contractors La�v 1827 RCW and <br />296�2001h'AC. /� n <br />u <br />FEE <br />�/ <br />�_�, � �� /D� <br />