Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8657 —www_evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� � � �P,r►� � (��.w'^^.� <br />PROJECT ADDRESS <br />Owner <br />Tenan! <br />L� ao� �' u�.� b�ve <br />Mail Addrnss <br />Mail Address <br />� � -� c�ut�L <br />Eleclrical Conlractor <br />) Q,� <br />Ci�y <br />Cily <br />gczz rJ�. q1=�ST va <br />Mail Address Cih� <br />.�65'�� �4� B N <br />Stale License Number <br />Proposed Use of Builtling <br />Square Footage Qf residen6al new construction, remodel or adtlition) <br />� —� '-�3 <br />� I 3p � -o°� <br />StatelZip <br />18 � ���Q'/ `c3 <br />�u� ` <br />Phone <br />State/Zip / I PO�� <br />Q.vL fi�� Q�°bZ y,3i•771 <br />State2ip <br />Phone <br />��t� 4 � <br />Contract Price of Work <br />�.,�-� �t�►�.e��-- <br />Con[act Person (Plan Review) <br />��-�, (�� �,,�.s'} Pl �L�.""— <br />Description of Work to Be Done <br />NOTE: WIPING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. ��) OQ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certity that i have read and examined this epplica6on and know the same to De (rue and � <br />correct. All provisions allaws and ordinanr.es governmg thrs type o/ work will bo. ccmplefed 1--� � <br />whetl,ei specdicd lierein ornof � he granting ol a permrt dces not resume to �ive authonty ro � �, �� C;t�s <br />vio�alo or cancel the prowsions of any otlier stam or local !aw re9uPting construcfion or the <br />pertomience ol construc(ion That I am aidhurized by the onner oi this property to pedorm the <br />�vork (or wAich eippGcaUon is rnade and I compty with fhe State Contraclo�s Law 78.27 RCW and <br />296.200 WAC. <br />��13 <br />