Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /�5� � �(�aN� h'v� — <br /> PROJECT ADDRESS <br /> /U�a G�',�,�' f'r�e !�i/�.-rT �•J> i�a"� <br /> �- <br /> Owner Mail Address Ciry State/Zip Phone <br /> Tenanl Mail Address Cily Stale2ip Phone <br /> ��G. -� E�ur'/.G ��l/ 5�� �7(��7(�C� �C��i1� G�'N22:��•�� �t�� /�y��7 �/��i.�� S�•f?pi <br /> Electrical Conlractor Mail Address Cily Stale/Zip Phone <br /> �J,�,�i���� iai �,� �9�1'l/i�� i����; <br /> Slale License Number Contract Price of Work <br /> Proposed Usc of Building Conlact Person (P�an Review) <br /> f,✓�/' �/>- .''u <br /> Description o(Work lo Be�one: � o � G'i�= ���^ <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 /> 1 hereby certily O�at 1 have read and examined this applicalion and kno�v the same to be true and , <br /> correct All provisions o!la�vs and ordinances governrng this lype oI wo�k will be completed COIGG "rJ '-«L <br /> whelher specfied herein nr noL The qranting o/a pemut does nof'�resume to�ive authonty to <br /> violate or cancel B�e provisions of any ofher state or local law regu ating construction or fhe <br /> performance o/construcfion. That 1 am aufhonzed by fhe o�vner cl fhis property to pedomi the <br /> work(or�vhich application is made and I comp/y with fhe Sfafe Confractors Law 18.27 RCW and <br /> 29�.200�NAC. <br /> �/� � -�%���/ �.,�5 �.�� <br /> Si9nalure � Date <br />