Laserfiche WebLink
i - <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 96201 <br /> � 425-257-8810 - FAX 425-257-8857 —www.everethva.org <br /> I i -as�� 3 <br /> � APPL�CATIONS ARE ACCEPTED FROM 8 AM TrJ 4 PM C �3D� "��� <br /> �f u2 � I�ir�� P,�-�v� <br /> PROJECT ADDRtSS <br /> � 4� l Z 7 ��( �� �v�'e-�fi l,1�t � �SZC � <br /> 1��_��3�� l��-`f�� �,•a.� � cl �v V <br /> Owner <br /> � Mail Address � Cily StatelZip Phune <br /> Tenant Mail Address City StatelZip ?hone <br /> KZ$ ?yC - �� � <br /> 9. .�: 3 <br /> 1)�["5 � � � � F� i 1� � "' >r, 1 r1 c �l+ ��=�:tti�T' t�.�fi � Phone <br /> Elecirical Contractor Mail Address City StatelZiP <br /> +`� �L t=�T '� :� u 4 Cs:v,�-.c <br /> State Lic—ense Number Conlract Price of Work <br /> p ��..��,� _ <br /> Proposed Gse of 8uil'ding Conlacl Person (Plan Review) <br /> Square Footage Qf residential new construction, remodel or addition) <br /> Description af Work to Be Done: .- '�<_ � �' � � 1 � �`'" � ``' � " �' <br /> -� <br /> � �r- � fi s. � or ..n ( � _ - <br /> I� i <br /> I NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 8E IN RACEWAYS, MC OR AC CABLE. �� �� <br /> � ', <br /> �� CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerfily that 1 have read and examined fhis zpplica(ion and knoiv�he same to be tn�e and ��� I �/ <br /> correcL All pruvisions o(laws and ordinances goveming this type ol�vork will be completed � --� r <br /> ✓dh.elherspeci6ed herein ornoL The granfing ola pem�d does not�reswne to give aufhonty(o <br /> violate orcancel the provisions o/any o(herstate orlocal law regu ating consWclion orthe <br /> pedomiance olconstiuction. Thot 1 am aufhonzed by fhe ownero/this property to per/onn the <br /> wo�k(or whicb application is made and 1 comply with the State Contraclors Law 18.27 RCW and <br /> � 296.200 WAC. <br /> I <br /> � ��.w� �c i�-l— 1 - 1 S .. I 3' <br /> Si nature - — Date <br /> �.___._9__- ._ _---__ —_—_—__. . <br /> ..,r— <br />