Laserfiche WebLink
ELECIf RICAL PE�IVIeT APPLI(;ATION <br />CITY OF EVERETT PERMIT SER1/ICE� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 -- www.everettwa.org `J - 3 �-� j <br />APPLICATIUNS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />2 i L. sr.n l�r <br />PRO.IECT ADDRESS <br />l, /1 �rFe� �7,'�% ic� K� <br />�c5(� �—Iz� <br />�u���ff �.,�s �he� 8�2h9�,�;�i�,,�/� F�f� wk P��'3 ;�uzS��3y� <br />Qwner Mail Address Ciry SlatelZip Phone <br />Tenant <br />Electrical Contraclor <br />Slale License Numbcr <br />Proposod Use of BuilAing <br />Description of Work lo Be Done: <br />Mail Address <br />Mail Ad�Sress <br />�tiJe 4nol �/�[9 �cr <br />r7/'tCfFbh � O <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY �F LVERETT �OCAL SALES TAX CODE IS 3105 <br />City <br />City <br />SlateRip <br />State/Zip <br />�h ��L <br />Contract Price of Work <br />Conlacl Person (Plan Review) <br />jien CJn �+'��k'✓ q, <br />1 hereby cenify (haf I hav� rcod and examined fhis applic�(ion and kco�v lkr. san!e to be Gve and <br />ro�req. All p�ovisions of laws and oniinances governmg this (ype oI work u-ill be completed <br />whelher sp=cdied hersin nr not. i'nn granting ola pernuf docs not prc�.�wne to give authority to <br />viola(e nr cancel fhe pro�isions olany ofher stata or localla�v regwatin� construc6on or the <br />per;nrrnance o/ consfruchon. That 1 am authorized by !he o�vner ol thrs prope�ty to penom: r:�. <br />u-ork Ior whi�fi ;:�plication is made and I co��iply wifh it,e State Contractors Law 7A.27 RC�. :, ,i <br />296.200 INAC. <br />�k �o� � �?-GYd <br />FEE <br />�= �'SG' 7 -11 ( <br />Phone <br />Phone <br />