Laserfiche WebLink
ELECTRICAL PERIVIIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, �VA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —�nvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � I <br /> � � 5 IiUII /1-V� ZUihF't� <br /> PROJECT ADDRESS <br /> , <br /> \ �'-G ��<.�iLCi l-mt.v'T <br /> Ownef Mail Address City StatelZip Phone <br /> Tenant Mail Address City Slate2ip Phone <br /> �� �L ���u%�Lrc— �tiC �',O•l3c�k�f1� �—�.11WCoi� �v,'w yk�,3� �t,�;; Iyo� <br /> Electrical Conlraclor 67ai1 Address city State2�p Pnone <br /> �I�11 k1=`T Ic•I<(< .-�sOG,° � <br /> Slale License Number Contracl Price of Work <br /> 1..�I..w-��ztiC,� <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> ���%��i`ir25 G llCuiF <br /> Description of lhbrk to Be Done: �-`�� �'�ti�'� �r���%TZ� �'( � <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> I <br /> i CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hersny certily that I have read and examined Ihis 2pplicafion and kno�v fhe sarne to Ge Vue and <br /> correcL All provisions o/laws and ordinances,qovernmg fhis fype ol�vo�h will be compleled <br /> �vhether speci(ied herein or not The granfing o(a pernut does nol presume to give authority to <br /> violafe or cancel ihe provisions ol any other state orlocal law re�u/afing consfrucfion or the <br /> pedormance o/consfrucfion. Thaf I am aufho�ized by Ihe owner of this propeRy fo perform the <br /> �vork Ior rehich application is made and I cornply wifh fhe Stafe Coirtracfors Law 78.27 RCW and <br /> 296.200 WAC. �, � <br /> , ' <br /> ; % � _ -:�% � •--- 5 -l:s -�� <br /> , i �, - <br /> ignaWre /' Date <br /> ., � �•�v& -��i5 <br />