Laserfiche WebLink
ELECT�IC�'�L PERMIT APPLICATiON <br />CI���'Y OF EVERETT PERMIi SERVICES <br />3200 CEDAR STREET, E'JERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIOtdS ARE ACCEPTED FROM 8 AM TO 4 PM <br />���/ �/,C %� �/ 1; Yl,: CY% C/,o , �- ; <br />c <br />PROJECT ADC�RESS <br />/ <br />�tr�', � 1,i,�i�I/r(ir;�i;'i�; =;r/2 lr�it;i,�-r-� �L E vri�?7 l✓+s �iPZa� /✓�A <br />Owner � �- Mail Address City Stale/Zip Phcne <br />Tenant <br />hlail Address <br />City <br />SlatelZip <br />Phono <br />';, ;; ,,�,; ii� �-�y e�rr'r1.ri�= �7zZ-/Gc�7''s7 si.JLy.v.vedo�o wA9&637 �%z�7�/t•7z <br />Electrical Conl�aclor Mail AdCress Ciry Slale/Zip Phone <br />� <br />f/; i �l C� Ni= 7G �/ � f' <br />State License Numbcr <br />Proposed Use o( Building <br />Description of Work to Be Done: ��'-' ��' �� l%/= .: �: ��� ��u '�U M I� <br />�— <br />NO'fE' WIRING IN NON-DWELLINGS IS RE(�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 31 JS <br />"'�OdO, Ud <br />Contrect Price ot Work <br />.'S%JIn/ �pC.-✓iGr �Z <br />ConlaclPerson (Plan Review) <br />1 f�e�eby certily fhal I have read and exarnined fhis application and know fhe same fo Ge true and <br />correct. AU pravisions ollaws and ardinances c�overninq fhrs type ol wo�k will be cornpleted <br />�vhefNer spec�6ed herein o� noL The �ranfing o/ a perrnR does not p�esurne to �i��e aufhonty lo <br />violale or carcel fhe provisions oI anv other sfale or loca� law mgulating consln�cfion or:!ra <br />peAormance oI construction. Thaf I am aufhorized by (he owner o` this pm�e�iy to pedorm m,� <br />wo�ic /or �vhich applicafion is rnade and 1 cornpty �sith fhe Stafe Con;�ac(ois�Law 18.27 RCW and <br />296.200 WAC. <br />� �r <br />� <br />i. : � <br />Signature <br />S - <br />FEE <br />� � ���o S—1 �l <br />