Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,� - i �/-�n <br /> (` � 7'�� h' � <br /> PROJECT ADDRESS <br /> /��,�j�lN_�i� ,`<' � ��i� I �r,r �i ',C 1' i : o•'_ l� l�>�� � [G•-�C/ /��:� �J <br /> Owner Mail Address City State2ip Phone <br /> Tenan. Mail Address City Slale2ip Phone <br /> �/�S <br /> F 1,-,� �� .�.ti l (r � ;,�.JeZ••� �r��l� Sl` �' '-�,� . ,��t� C� �7 l�tsc�' �7i�33n <br /> Electrical Conlractor Mail Address City Stale2ip Phone <br /> � <br /> f�j� �:r,.� F�, l/'�/�.� <br /> Stale License Number Contract Price o(Work <br /> l <br /> �'� ��J <br /> Proposed Use o�Buiidin� Contact Person (P�an Review) <br /> Descriplion ol Work lo Be Done: ��-'`-' •���' �-�� ����r�i ���� ��I `� �� � l��G� <br /> � � 1 ., <br /> %J �:_��'._. � I�C) V l .2( •.,���.5 <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ce�tily that I have read and examined this application and kno�v the same to be true and <br /> correcL All provisions ol/a:vs and ordinances governmg this type ol wark�ti�ill6e completed <br /> �vhether specilied hercin or noL The g�anting o/a pernuf does not resume to give aufhonty to <br /> violate or cancel fhe provisions ol any other sfale or local law reguPting constructwn or tbe <br /> perfo�mance oI construcfiorr. Thaf 1 am authonzed by the owner o/fh�s property to peAonn fhe <br /> work lor�vhicb applicaiion is made and!comply wifh the Sfate Confracfors Law 78.27 RCW and <br /> 296.200 WAC. <br /> �.�.c� � . � (R :_._�� � �: �—Cs� <br /> Signalure Dale <br /> � � Zv <br /> -"� 0� <br /> i <br />