Laserfiche WebLink
� . <br /> ELECTRICAL PERMIT APPLICATIQN <br /> CITY OF EVERETT PERMIT SFRVICES <br /> 3200 CEDAR STREET, EVERETI", WH 98201 7_ 1 � 0� <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> L Obo7�0� 0 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> .��/�O L- C .�'� I�A✓ C� /'�N-e� <br /> PROJECT ADDRESS <br /> 13. �� �' I�s� i-� � b ��,� ��� ,�l-�e� L�� t�'/I `td' ad1 <br /> Owner Mail Address City Stale/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> t-� C` 1� �bl.i�/�G�(�' 1 ��'�^- 1��� �L ` <br /> Eleclrical Contractor nnail dress Cii� Swteizip Phone <br /> 2� Ar,C.oiv C IG 5 ��� o <br /> State License Number Conlre;l Price o(Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description of Work lo Be Done: ,LC 6�-1�L�- Y�«� � �-'YY�' `+- � �Y�^ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> f CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhat 1 have r'ead and exarnined fhis application and know the same to be true and <br /> wrrecL All provisiau o/la�vs and ordinances governmg fhis fype ol wak will be complefed <br /> �vl�efher speaGed herein ornoL The granling o(a pernuf does not presume to give aufhority to <br /> violafe or cancel the provisions oI any ofher state or local la�v regulating construction or the <br /> pedorrnance o/construction. That 1 am aufhonzed by the owner o(this property to perforrn the <br /> �tirork(or which applicafion is made ar;d 1 compl}��vith the State Contraclors Law 18.27 RCW and <br /> 296200 WAC. <br /> ^ � /- � <br /> ��^-"-- � A---�_ <br /> Signature Date <br /> ;_/ <br /> - (.�4:'G'/ '�;�!(. <br />