Laserfiche WebLink
�LECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM II �O �`�O <br /> E07//.AO/ <br /> � z zz l�.�M��F�,���r� t� <br /> PROJECT ADDRESS <br /> � �! �",F-tir���--1� � � <br /> Owner Mail Address City StatelZip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> yL� �� S7Jr) <br /> �i�r,�r^\fi Ci.�c-r��� Ir�� 6w3 �w�5fi 5-'" Nc.� �N�a�=� wA �i�Z�,2 <br /> Eleclrical Contractor M11ail Address City State2ip Phcne <br /> ��i�,nMl� l Gt)O �Z. I � O��J <br /> Slale License Number Conlracl Price of Work <br /> -f�IZI FLC-_k — <br /> Proposed Use of Building Contac!Person (Plan Review) <br /> �(,u r.�'1 6:-'_� <br /> Description of Work to Be Done: �.J i�C N �t"� �� ��� �""E <br /> � <br /> tJOTE: WIRING IN NON-DWELLINGS IS R[QUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> II'I 1 hereby cerlily that I have read and examined fhis application and know fhe same to be true and <br /> r.orrect. All p�ovisions ol laws and erdinances govenung lhis type o(�vork�vill be completed <br /> �vhether specdied herein or not The granting ol a pernut does not presume to give authority to <br /> violate or cancel the provisions olany other state orlocalla�v regulafing consfrucfion or the <br /> performance ol conshuctiori. Thaf 1 am aulhorized by thu o�vner ol this property to perform the <br /> work/or which applicafion is made and/comply with the State Contractors La�v 18.27 RCW and <br /> 296.200 WAC. <br /> Z <br /> � <br /> r�- ���� ---_ ���� ; z��� <br /> Signature Da(e <br /> .���- C��� <br />