Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 s -'a �-� � <br /> 425-257-6810 - FAX 425-257-8857-www.everettwa.org L ��S-I 5 C7 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �2'7 � q �-�-��v���r ��� EJL�z.c=?T �.c��l <br /> PROJECT ADDRESS <br /> 3 Cc.�� <br /> C-�P'L� wl`�-4L.1 �IS 4f� I'-� I"-+ T� 14 �� I�1L V1'lAwl[S�l �i� u�A.`110- DO�g <br /> Owne� Matl Address City talc2ip Phone <br /> J�� c- �N�C <br /> Tenan� Mail Address Cily StatelZip �hone <br /> 4v <br /> ��� - C.Lv��4 � �-1 =r��� t���rt�o� �t31 Anl��o �!-�S ItiA, �1�ZLl 5�f'� -/Z �i <br /> Eleclrical Contractor Mail Address Cily State/Zip Phone <br /> I�i c_e�� �i �-1 f� D2 l���I IIC � �, `�DD <br /> State License Number �' Contracl Pnce of Work <br /> `3Cc0 <br /> OFt=��i � 2� -1 �.\ 'Icr�,� k�crlydr� ��c: � - 2�`I3 <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work lo �e Done: �1��� �Jc- i�'L� �C = ' �i=� ; �,V� �L� 1�-Q <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ce�tily fl�at 1 have read and examined fhis applicafion and Wiow fhe same fo 6e tnie and ,G <br /> correcL Al/provisions ollaws and ordinances�overnmg fhis type o/work�vill Ge wrnpleted �`'�'�S - �SD <br /> whether spealied herein or not The granting o/a pernut does not presume to give aufhonty to <br /> vio/afe or cance!the provisions ol any other sfate or local law mgulating construcfion or fhe <br /> peilormance of construcfion. Thaf 1 am aulhonzeA by the owner ol th�s property fo peAomi fhe <br /> �vork/or which applica(ion is niade and 1 cornply with fhe S!ate Confracfors Lew 1827 RCW and <br /> 296.200 L1�AC. � � ! � <br /> C ( <br /> �� : = \L��_ ' � 2-$ ( �'8 <br /> ,�`' Signat ire � Date <br />