Laserfiche WebLink
ELECTRICAL PERMIT APPLICATIOiV <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> i 1 ' <br /> I �� �' �1 ) Il;��l (�_ ��I <br /> PROJECT ADDRESS <br /> �I� �n ��� Cv � Z1>j Fn�a�n , �v �ni�����nc� Cr� � ��('C�� — <br /> Owner Mail Adaress Cdy StateZp Phone <br /> �V ��C� I I 1'�'`�"IC�`' �3�C �r'l�ih�i4.5� ��D� I-ti'P(t'-�-� w' � � <br /> Tenant <br /> Mail Adtlress City SlatelZip Phone <br /> C'Fl�'�L�Q„�,n�n,l� �i��l�n�, �f � �B�x '��t�5 K� ,� kln,Yl LvA �`1f��E�� `�as-£�2�-(z`i> <br /> Electrical Contre or Mail Address City State2p Phone <br /> (' F1�1NE �h1`153�� � �' c°�� <br /> State License Number Contract Price of Work <br /> (�����( CI' � � l 'Ci��(' �'lr�l ���' <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Square Footage p(residential,iew construction, remodel or addition) <br /> DescriptionofWorktoBeDone: � (1 ���lll 1 ��fLV �"��✓n�(��>���—� <br /> I <br /> � NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �O�O <br /> � <br /> I CITY OF EVERETT LOCAL SALES TAX i.ODE IS 3105 <br /> 1 heroby certily fhat I have iead and examined!his applicafion artd know the same to be Vue and �(�I � _ h�� I <br /> ccrrect. All provisions ollaws and ordinances gavemmg Ihis type ol work will be completed I V I <br /> �vhelher speciGed herein or noL Tho,qranting o/a permd does nol presume to give aufhonty to <br /> violafe or cancel the provisions o!any ofher slate or local law regidating consfrucfion or fhe <br /> perlormance ol consVuc6oa That 1 am aufhorized by the owner o!fhis property to peAorm fhe <br /> �roork lor which application i;made and I comply wifb the Stafe Coniraclors Law 7827 RCW and <br /> 298100 WAC. <br /> 7 <br /> i J ] / /� <br /> �U�� C, •�/ /(• C �L i <br /> / J l. ) J�� <br /> Sgn�Kre Dale <br /> I ___ _ _— <br />