Laserfiche WebLink
1 <br /> 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 /> PROJECT ADDRESS <br /> ��i l <br /> 611^� �l l,P� c�' �_��C C �S �F^ �vPVe �J� ��� U j <br /> � wn r A1ail Address Cily StatclZip Phonc <br /> Tel t `—��Ly t�,�� Mail Address City Stale2ip P�one <br /> �'�G°5r � �-� L �{- <br /> SLlM� C� o ���� ��I � ��� 1�✓ �QV 2l � I/�/—I ��Z� � <br /> Electri I Conlractor hta�l Address Cily State2lp Phone <br /> ,����s� � � �3 � NA ��il��I i � 9 �� <br /> Slale License Number Conlract Price ol,W�r� _ � 1 z �i <br /> ��C ��y `f l5 <br /> Rz ; � �f� � se <br /> Proposed Use o(Building Contacl Person (Plan Review) <br /> Descript�,on o(Work to Be Dono: I'l�S' l � � I < <� /'1 �P r �(it ( Q <br /> �cr /19 P in! InI� �� r �,���+ ? C To /�o n f P J�1 yl P <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 G 1�� <br /> 1 hereby ceAily fhaf 1 have read mid exarnined fhis epplicufion and kno�r fhe same fo be We and �UOby� <br /> conecL All provisions o(laws and ordinances govemuic�fhis fype o(�+�ork will be conrpleted <br /> whether specilied herein or noL 1he granling o/a pennrt does nof rnsume to c�ive authonty to <br /> ��iolate or cancel fhe vovisions o/any ofher sta(e or local law re9uPfing consfruchon or fhe <br /> perfonnance o(cons�nicfion. That I am airtho�ized by fhe owner o!this prop�rty to perlorm fhe <br /> work!or ahich applicafion is mado and I yornpty wifh Oie Slafe ConVacfors Law 18.27 RC W and <br /> 29G.200 6VAC. i <br /> � � i <br /> `�, — i-.�� � � <br /> � `��4�G�1�'l.��c✓�- <br /> SighaWrc Date <br /> L <br />