Laserfiche WebLink
ELEC�'RICAL l�ERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CFDAR Sl"REE'i, EVERETT, WA 98201 �2� d�'C ' <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org [- oSl Z-O�� <br /> APPLICE.:IONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> j :;ii �j �U w. �j, �� N.U� <br /> PROJECI"ADDRESS <br /> 3�4-/7�3 <br /> T-��k�?I�' �)•�{I1 D i,, ��J `Z.l S (-L>iM��c ; L Vy'k^v'.� (iLA ���2C'( <br /> �i �- <br /> Owner Maii AJdress Cit <br /> Y State/Zip Phone <br /> Tenanl hlail Address Cil <br /> Y State/Zip Phone <br /> ��.(-� i1 ! N j <br /> Eleclr,cal Contraclor Mail Address Cily Slale/Zip Phone <br /> �n�n�:X � � oc� <br /> Stale License Number Conlracl Price of Work <br /> hl�a'�'� i �( y i,vU �ti'� ,'Vli r�tQ'�( C'l�� ; ; <br /> Proposed Usc o�Bwlding Contact Person (Plan Review) <br /> Description of Work to Be Done: _ ��'*' �✓i 1��' �'L� �'GP� -Z ��, �. I l 5 ��,v ( o�� l�,p�h �C�`���,4,� <br /> � ,� t 1 C_i �'v1 ��'4 ( Y} � �^ (��V ��L�- <br /> _� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIR[D TO f-EE <br /> � 8E IN RACEWAYS, MC Or2!�C CABLF:. <br /> i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> II hereby cerlity(haf 1 have rea:i�nd ezamined this application and know the sarne to be true and " " J� <br /> correcL AlI provisions oI/aws and oi:+-�;ances go✓ermng fhis type o(work will 6e comp/eted � � � <br /> �.vhether speci6ed herein or nor. 1 hP gran(inc�oI a aennd does not�msume to give authority tc <br /> perlorm��ce�olco/ns�u�tio�or�That�l.��t�u(horzedbytle/o�ier9o(thi propertyttope��mithe <br /> work Ior�vhich opplicatien is made and I co�nply wi(h th�Stale Cuntractors Law 18.27 RCW and <br /> 29f.200 Ih�AC. <br /> Sic�naturc Date <br />