Laserfiche WebLink
JJL.-c3-��SO 2?:45 From: To:257�257 Paee:i�l <br />��� <br />PROJFC7 ADDRESS <br />':�. <br />FLE��RICAL PERMIT APPLICATION <br />.j CITY OF �VERET7' PERMIT SERVICES <br />.;��;• 3200 CEDAR ST. REET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everelhva.org <br />ApPL.ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />7 �� G -/a <br />�1007-11 Z <br />�t� (����;� <br />' �' ��� <br />L; <br />C�� �� �� <br />�J � <br />O�.�ner '.1ail Atldress Ciry Sl6to/Zip Phone <br />� <br />EleGrical Conlraclor Mall Address <br />�SO➢UIT� � �'��D7 <br />Stale Liconsa Num6er <br />����, <br />Proposod Use ot Building <br />►LPCP� U�}h cl � 701 � -�� <br />City Stale2ip Piiw+e <br />� <br />Conlr2ct Prlce of Wurk <br />�er� 5h�ur�4�'" <br />Contaci Person (Plan Review) <br />NOT[: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE � <br />BE IN RACEWAYS, MC OR AC CABLE. � <br />� � <br />CIIY OF EVERETT LOCAL SALES 7AX CODE IS 5105 <br />I heraby certify fhaf I hsve rend anJ examined fhls application and know 1he samo fo be (rue and �(CJU� '� �� <br />cor,ec(. All provisions ollows und o�dinanees govern,ng fhis rype ol wurk will be complefed <br />��•helhor speciliod hereln ur noc Tho �rantinr� nI o permrt does na( presume to give aufhurity fo <br />wolafe or cance/ tha provislons o/ any other stafe orlocn/ low �egulafing consl�ucuon or Ihe <br />pedonnonce oI construCfion. rhet I am aufhorrzed by the owner ol fhis Properly to peilorm fho <br />work for �vhich application is msdc anA! cornply wifh fhe State ConVaclors La�v f0.27 RCW and <br />ona ,nn u,.,,. <br />v .ny��w�u�c Ud19 � <br />��°� Cc.�-�.Q 4 �" � � � " a5 i-I .:� <br />--���1n P��n.�-�-� Gri�our�' ._.. _�- . <br />P . � ��_ <br />