Laserfiche WebLink
- — i <br /> � ELECTRICAL PERIMI�i APPLICATION <br /> � GITY OF EVERETT PERMIT SERVICES <br /> I 3200 CEDAR STREE�, EVERETT, V'JA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /1� iao✓rm y Sr -/3iv6 � -S.r� _ <br /> PROJECT ADDRESS <br />� I <br /> �,ri,�r/a� .�l���r�i�r ��r�D S•�t�1rr� �%/...i TKw.�,o- !/�� � <br /> Owne� Mad Address Ciry State/Lo Phone <br /> Tenani Mail Address Cily Sla�elZip Phone <br /> I In c I M11 h ral S � P fl Rn 7fi4Q R dm nri ln�A 9R(179 d7S-AiiS.olIlO <br /> ElectriCal Contractor Mail Adtlress City SlatelZip Phone <br /> � <br /> UNIVEMS014KQ 6 � -- <br /> Sta!e License Number CoMract Price of Work <br /> � �GG �/ 7S� f,st� N�GL� �I�.�`{QS"1�� <br /> Proposed Us of Building Contact Person (Ptan Re�.iew) <br /> � �escription of Work to Be Dorie: I�STA�� )Tf .�z� 3� �'���� �'`�`����� r�'�� <br /> , �� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE !N RACEWAYS. MC OR AC CABLE. <br /> 1 <br /> i CITY OF EVERETT LOCAL SALES TAX COUE IS 3105 <br /> ' !hereby certdy that!ha�ie read and e.ramined fhrs applicafion and know the same to be frue and � I <br /> � �ormct. A!1 provisior.s o(laws and ordinances governing this type o(work will be complefed � n _ 1 <br /> � � w,hether specmed herein or not The gran6no oi a permd does not presume to give authonty ro �yl I <br /> nolafe or cancel the provis�ons of any ofher state or local law regulating construcnon or the �1 <br /> i �� :;erformance o/construcfion. Thaf 1 am autY,onzed by;he owner o/this property to peAorm the <br /> �� � `.�oilc Icr which applica(ion is made and I compty with the Sfafe Contractors Law 18.27 RCW and <br /> °95200 WAC. � / <br /> , _---� > y�G6 �D �, i c <br /> i J <br /> � � SiqnaWre�� Date / <br /> ✓ / , <br />