Laserfiche WebLink
r- <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES 4 _ 5-0,? <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — vmw.everettwa.org 0- <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />�C�ti�l ; S�at/yP J�a� I?�IIOwV9 /P Pl- 1_ ✓P✓� t �.l ��a U y <br />Owner Y Mail Address City Slate/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />Q wit e✓ Pe f <br />Electrical Contractor Mail Address City StatelZip Phone <br />Stale License Number Contract Price of Work <br />Proposed Use of Building c� L1 /I Contact Person (Plan Review) <br />Description of Work to Be Done: a00 A I/ G- S �✓,' CP Ol t^ <br />:0f V1eW lo) <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 l .CMG �! _ I C <br />1 hereby certify that I have read and arnined this application and know the same to be true and J <br />correct. All pro ions of laws af+d o is antes governing this type of work will be completed <br />whether spe to herein orXs <br />The gr nting of a permit does not presume to give authority to <br />violate or c cel he pprovisiolts of any titer state or local law regulating construction or fhe <br />performs a ofconstructi .That 1 a authorized by the owner of this property to perform the <br />work for hic application' made a d I comply with the State Contractors Law 18.27 RCW and <br />296.20 <br />Signature Date <br />