Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY �F EVERETT PERMIT SERVICES <br />3200 CEDAR STREET EVERETT WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org �I ' � � � � �' <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM L b(�U I- C%-J6 <br />i - � <br />PROJECT ADDRESS <br />�">/�: <br />Owner <br />Mail Address <br />Tenant Mail .4ddress <br />�r <br />�" >�;.� '��i/ %.s' - S �� <br />Electrical Conhactor Mail Address <br />i, 1 `, I / _k' :t— c'„u- /r5 �' <br />Slalo License Number <br />Proposed Use of Buildinc� <br />Ci�y <br />City <br />i. c I, <br />Ciry <br />Description of Wark to Be Done: �' � ��•. � <br />. , <br />r � � <br />State/Zip <br />State/Zip <br />i `�'S�� � <br />State/Z�n <br />Contracl Price oi Work <br />Phone <br />Phone <br />; ;� J�yl <br />Phone <br />Contacl Person (Plan Review) <br />NOTE: WIRIN, 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 certify fhaf 1 have read and examined this ap�ilicafion and know the same l0 6e Irue and <br />correct. All provisions olla�vs and ordinances govemmg fhis type ol work will be wrnpleted <br />whether spec�fied hemin or not. The granfing ol a pernut does not presume to give ,� rthonty fo <br />violafe or cancel fhe provisions of any ofher state or local law regulating consWcboi �r the <br />pe�fomiance o( consiruction. Thaf ! am authonred by fhe owner o/ this �roperty to � �`orm Ihe <br />work lor a?iich applicofior� is made and I compty �rilh fhe State Contracfors Law 18... % RCW and <br />29E. Z00 WAC. <br />. /-- <br />SignaWre � . <br />� �c c <br />� ��� <br />_ h � / <br />�7 <br />Gl rn.�ll <br />� � <br />