Laserfiche WebLink
i^ <br /> ELECTRICAL PERMIT APPLICATION <br /> CITX OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810 - FAX425-257-8857–www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br /> ,.711!1 � 1 1 \r'1ClCT�P �Io,is..�— <br /> PROJECT ADDRESS <br /> �a..5' � <br /> iJo� , n, C�li�'�ury���,�o� � �'��l�e ��sarn� �$�c�3 �-� <br /> pyvner Mail Address City Slete/Zip P�one <br /> Tenant Mail Address City Slate/Zip �`�5.aaQ t 1 <br /> -n c F'�P c�-�-;� T� ��� F n�.rc �('�n�`C�� l,�A q� <br /> Electripl Contrador —r Mail Address Ciry State2ip Phone <br /> �LCZ1-Tq�--a (� tJ�-� ��� J`.�� <br /> State License Number ConhaG Price of Work <br /> \ - T(�M S��r� <br /> Proposed U e of Building Contad Person (Plan Review) <br /> Description of Work to Be Done: L-,1 ��^ C' � �� � ', <br /> o2C� (.����i'��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 ����_ n r�f� <br /> I hereby certdy that 1 have read and examined this application and know fhe same fo 6e hue and <br /> lh7 a <br /> correct. All provisions o/laws and ordmanres goveming this type ol waA will be completed <br /> whether�p�ed herein or nof. The granhng o/a permR does not resume to g'rve authority to <br /> violafe a cancel the provisions ol any other stafe or local law raguP6ng consfrucfion or the <br /> peAwmance o/construcfion. That 1 am aufhorized by the owner o/fhis property to pe�/am the <br /> work/or which applicafion is made and 1 canpfy with the Sfate Contracf�rs Law 1 P 27 RCW and <br /> 296.200 WAC. <br /> �o�,-,,, �`�(�"1 �P,.�C� q� 11�c>G <br /> Sgnature , �e <br /> � <br />