Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-25?-8810 - FAX 425-257-fi857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />PROJECT ADDRESS <br />�����,��a� �3.����� ���o;��U�c1 U� �vA� <br />Owner Mail Address <br />Tenant <br />Electrical Contractor <br />State License Number <br />propased Use of Building <br />Mail Address <br />Mail Address <br />City <br />City <br />City <br />�, , i �l <br />` L <br />. � �� ��,�� v � I���I _ <br />State2ip <br />St�te/Zip <br />State/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />u< <br />Description of Work lo Be Done: �� � � � � '� ` � ���.� �� � �� � �� � � �'� �� <br />NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CUDE IS 3105 <br />I hereby certi/y that ! have read and examined this applicaficn and know the same to be true and <br />correct. All provisiors ol laws and ordinances governmg this type o( work will be completed <br />whetherspecilied herein ornoL The qranfing o(a pe�md does not presurre fo give authority to <br />violate or cance/ the provisions ol any other srafe crlocallaw regulating construction or the <br />peAormance o/ constr�chcn. 7'haf 1 am autho�ized by the owner of fhis property to peAorm the <br />�vork lo� which application is made and I comply with fhe State Contractors Law 18,27 RCW and <br />296.200 WAC. <br />1 � '� \) `�, V �'��� � .._ ` . <br />� -�z0 <br />��� �I� <br />FEE <br />-5���.� 1 <br />Phone <br />Phone <br />Phone <br />