Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org �j -�b'-/D <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C/OO� �-I�/ <br /> ,� ,' � �-- L UrYI%l�i� <br /> PROJECT ADDRESS <br /> �i�NRi�fP �U/l�S�. �1��/�k ��f'�� , <br /> Owner Mail Address City Slate2ip Phone <br /> Tenanl Mail Address Cily Stale2ip Phono <br /> �����C' � c'�PcT i3C�U3— zG�'�`'�% Sf Stio j<�n��ir �-r �'���� <br /> Electrical ConUaclor Mail Address City State/Zip Phone <br /> �IGi,����� 9�s�' � - ��17 �� � /, o� �.. <br /> yz�=v��-;3�� <br /> Stato License Number � � � Contract Price of Work <br /> �PS�:CI P/IC �_ <br /> Proposed Use of Building Conta:l Person (Plan Review) <br /> Descriplion of Work to Bo Done: -���v'/L �' �/✓C� ����1�.`�� ' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceRi(y fhat l l�ave read and examined(his applicat%on and know fhe same to be We and �. I�1 � ` �I"� 1 <br /> correct. All pr'ovisions ot laws and nrdinances goveming fhis fype o(work will bo completed <br /> �vhether specified herein or not. The granting of a perrnd does nof presurne to give authonry to <br /> viola;e or cance/the provisions of any olher state or local la�v regulating construction or the <br /> per/ormance of construcfion. That 1 am aufhonzed by the o�vner o(fhis�roperty to per�onn the <br /> �vork lor which application is mado and 1 corr�ply wifh the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ,�-� �� . � �� �/l� <br /> ' ' �il�' l��"— <br /> Signature ��-' � Date <br />