Laserfiche WebLink
� ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 99201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> �� � �'l �'��_U/J?l�.` � .7�/2 �C�/�°.�eTT C_e) 4i /J� �� <br /> PROJECT ADDRESS� —� � <br /> ,��/q—,- k'Pk/ �- ���' i.�� �c._. T�a1 �c�c�7j� ,� �J��,'s�� �?� <br /> Ow�e� Mail AAdress City State/Zip Phone <br /> �3l00 - 6 S8-o'��� <br /> 3La -�,5`/ -��D� �/C <br /> Tenanl Mail Address Ciry Slate/Zip Phone <br /> Electrical Contraclor Mail Atldmss Cily Stale/Zip Phone <br /> State License Number Contrect Price of Work <br /> Proposed Use of 6uildinc� Contact Person (Plan Review) <br /> Description ol Work lo Bc Do�te:���)•Pi I L�/? lP C�/? � <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 <br /> 1 hereb}�cerii(y thaf 1 have mad and examined fhis application and kno�v the sante to be true and <br /> correcG All prov�sions olla�vs and ordinances�oveming fhis type ol�vork wi0 be comp/eted <br /> whefher specified herein or not The granling of a pernuf does not presame fo give authonty fo <br /> violate or i:ancel fhe ruovisions oI any other stafe or local/aw rer�ulaling constniction or Ihe <br /> peiforrnan,:e ol construc(ion. That I am aidherized by the owner oI th�s property to peAomi fhe <br /> wo�k lor which epplication is made and I comply wifh fhe Sfate Contracfors Law 78.27 RCW and <br /> 296.200 WAC. <br /> / <br /> � <br /> J. <br /> � % - � �/ / /1.�77�ti /�y) �� <br /> � S c�nalure Date <br /> �oSG7 -C7�/ <br />