Laserfiche WebLink
ELECTR6CAL PERMIT A�PLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9820'I 1 _ �rj_ (� <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> C-I/0 2-07 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��,�,? I-�r)�� j i�i.% .- <br /> PROJECT ADDRESS <br /> '� t <br /> � . � <br /> �- <br /> � )/� 0"';� � /���ilJti vi� i�rfc��n.JSan� I � � ,� f��/������� L �c��7T ��-' �� <br /> Owner Maii Address City � Stale2ip Phone <br /> �I8�0 / <br /> ;�� /,1- ��r� �i�,', :�i��a <br /> Ten3nl Mail Address Cily Slale/Zip Phono <br /> ��ll ��r—!C <br /> Eleclric;il Coniraclor Mail Address Ci�y State2ip Phuno <br /> Stato License Number Contracl Pdce of Work <br /> Proposed Usc ol Duildi�9 Contacl Person (Plan Review) <br /> Description ol Work to Oo Done: �L� � I N (_.(�d-�Y�'��y nL2 Y�(�_� <br /> J� <br /> NOTE: WIRING IN NOtJ-DWELLINGS IS REQUIRED TO �[E <br /> BF W RACEWAl'S, f�1C OR AC CAOLE. <br /> CITY OF EVERETT LOCAL SALE� tAX CODE IS 31Q5 <br /> I hereby certity fh�t 1 have read and exr�mined this applicafion nnd knoit�the s��+rrie� ro bc�truo and .. � ���.� �;��- ( <br /> correct. All provisions olla�vs and ordinances gerernmg fhis fy�pe oI work will be cornpleted <br /> whelhcr spea(md herein or noL The�rantin�o/a permit does not iresumo fo�i��e authonty fo <br /> violafe or cancel fhe prcvisioic;of an}�other state orlocal/nw re�ulafin�consVuction or Ihe <br /> perfomiartae ti/consiiuction. That I am authorized b}�the on�ner o/this property to pedonr fhe <br /> work/or.tii�hich application is madc and 1 comply��vifh fhe Sfafe Confrectors Ln�v 18.7.7 RCW and <br /> 29G200 WAC. <br /> �� % � - � <br /> �_1' r' C �"\ / � �.-�_ � .�%'��— <br /> __,.- <br /> — S:�nulure , _ Uate <br />