Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERElT, WA 98201 <br />425-257-8510 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />_,, �,,, , <br />�JfT �� /��ct !� ���C�lti iZ� �-+ � <br />PROJECT ADDRESS <br />Owncr <br />� <br />J�L <br />Tenant <br />�V�GY�N') <br />ElecVical Coniraclor <br />hiail Address <br />, <br />0 o!L / �,N <br />kMail Address <br />MY� ��) � <br />Mail Address <br />,�'1 Y �, � �i N � 91"� � �/ <br />State License Number <br />Proposed Use o( Buildinc� <br />7-�� -�(o <br />Citq Slale/Zip <br />�l/ L�;Q�s.c"�. ��vc� (—� �K, <br />City SWte/Zip <br />� I)O SW /"lNK�i�E,.� <br />Cily <br />Slate/Zip <br />ti <br />_.? � <br />Conlracl Price of Work <br />Phone <br />cti,� � y <br />Phone <br />'�'a�s. <br />Phone <br />Conlacl Person (Plan Review) <br />Description of Work to Be Done: �G1 S�<�` C G(�>���� L-C �J�-'�l-�'� J� <br />_ �r �?�c �-v��9 '� <br />NOT[: WIRING IN NON-DWELLINGS IS R[QUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify fhaf 1 have read and examined this applicafien and knoiv the same to be true and <br />correcf. �II pro�-isions o/la�rs and ordinances governmg fhis fype ol work will be compleled <br />�rhethcr speaGed herein or noL 7he granting oI a pennrt does not resume to give au(honq� fo <br />��iolate or cancel the provisions ol any other stafe or local la�v rec�uPting construction o� fhe <br />peilormance o/ conslrucfion. That 1 arn aufhonzed by the owner ol lhis pwperty to periomi the <br />work !or which application is made and I compl}� irifh the State ConVactors Law 78.27 RCW ond <br />29G.200 WAC. <br />� <br />��,���c�`� �/4 f � � <br />,�� <br />u,r�-�` <br />