Laserfiche WebLink
i <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wvvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FrOM 8 AM TO 4 PM <br />LIyJl� No.r1 A11Y <br />PROJECT ADDRESS If <br />II ;;)) <br />A f 1, e lo,ppe( ` `�A q '-tur FI/rrPTI W c� <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City Stale2lp Phone <br />t\.,,.,,.r �II.I EIr,IY;. y413 1110L h NE Awl,-Il�� W gdZZ3 42f-iZOT-12s <br />Ereclrical Conlraclor Mall Address City State/Zip Phone <br />h .C_� <br />Stale License Number Contract Price of Work <br />Propose Use of Building f Contact Person (Plan Review) <br />)) Description of Work to Be Done: I,l l,nA o+ Yee W n c� A 0, w.� � � Cc V r_C <br />IJOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not resume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this roperfy to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.20�0WAIC. <br />Nlt l' 7-G- 1� <br />— ig'n'ature Date <br />