Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICE� <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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />I o� i 5�o�rRN� L�t� N <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />KE LAN�J l� r� ES <br />Mail Address <br />Mail Address <br />City <br />Cily <br />State2ip <br />State2ip <br />Phcne <br />Phone <br />��uMM1t E�c.1'��c, (a c�j �bl St' ST NW STA ►J (,_k�O� (.�A 9`62`'i^� `iZ5 30� 5�S j <br />Eteclrical Conlractor Mail Address t:ity SWtc/Zip Phone <br />�,c )rn� 1 E I ao� I<L <br />State License Number <br />��r � <br />Proposed Use a( Building <br />Descriplion o( Work to Be Done: �.�f � <br />F-E n�Ei,� 51" (� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />�/5r,o <br />Contract Price of Work <br />Contact Person (Pian Review) <br />1 hereby certi/y Ihaf 1 have read and exmnined (his application and knou� fhe same fo be tnie and <br />correct. All provisions o/laws and ordinances �overning Ih�s fype of work will6e completed <br />whether specdied herein or not. The granfing ol a pernut does not resume fo yive aufhonty fo <br />violate or cancel fhe provisions oI any other sfafe or local law reguPting construcfion or the <br />pedonnance o/ consfruction. That 1 arn authorized by the ownero/ this property to perform fhe <br />work !or �vhich application is made and 1 compl}� with fhe State Coniractors Law 18.27 RCW and <br />296.200 WAC. <br />M <br />-��ZS- 05 <br />Date <br />� osc�� - � �' D <br />FEE <br />