Laserfiche WebLink
� — — <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF �VERETT 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 /> _7 , r� n <br /> ;'�%� z f-��,_..�- P ��,.�c-��� r3/d9 . <br /> PROJECT ADDRESS <br /> zLr�-`�' 3l - <br /> S�-u,�e�,��,�+'�i ,,l S�r��e��e�i ,��a �;L�.l�, �lc L F_vc sic, <br /> Owner Mail Ad ress City State/Zip �/S'2 C,� Phone <br /> ��Iti�''d�L� �Gf�-t���R (�j' 1 1 i � <br /> Tenanl ail Address City State/Zip Phone <br /> � !� I�lV� �' 'c-�- l L� I?J iJX?-�I�.�(�G-�c1•C�LI�/,�//e I�✓/`� 1rFd 72 <br /> Electriral CoNrador Mail Address City State2ip Phone <br /> / <br /> <,;L�� /Zl-F Li�l>t�C H (�f�� c�r�v•c'„ <br /> Stale License Number Contract Price of Work <br /> �/., � `� <br /> / ��, �^�c{«t.k � ��Z-P /��- - /' !: �^'� � � <br /> Proposed U&c�ol uil g Contacl Person (Plan Review) <br /> ?�r�� 3 s-� �yr�'" <br /> / ,�7`' � // 7 <br /> Descriplion of Work lo Be Done: _� 1 L� �Z- '�'L-��f�'`e��%�°-i �f{���- <br /> i � / <br /> —E,�='�L�= ✓ - <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �,-,O — <br /> � <br /> CITY OF EVERETT LOCAL SAIES TAX CODE IS 3105 <br /> I Irereby certily thaf 1 have read and examined fhis applicafion and know fhe same fo 6e frue and <br /> correcL A!�provisions ol laws and ordinances goveqiing fhis type o!work w;ll be compleied <br /> whetlrer sp^cdied herein or noL Tire granting o�a pennd does nol resume fo give aulhonty to <br /> violate or c�ncel th=provisions o/any other sfate or local law requPling consirucfion or lhe <br /> perfonnance o/consfruc6on. Thaf I am auffrorized by the owner o!fhis property fo perlorm fhe <br /> worA !or whid�application is made and!comply wifh fhe Sfate ConlraGors Law 18.27 RCW and <br /> 29G200 WAC. <br /> i�/ � <br /> � �;.� f���� �� n �/ <br /> ' �ti�, �u � �ii os ,� <br /> �`' Signature Date D <br /> {� <br />