Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-2Si-8857 — www.everetha�a.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />1 �� ���iJ�(�/.f�lv �L� — <br />PROJECT ADDRESS <br />r ti �� �.. <br />Owncr <br />Tenant <br />�. , Ko�- <br />Electrical Contrector <br />��Z`o' 1�,rzG+1ti �� <br />A1ail Add�� ss <br />� /�- VI/`� <br />A7ail Address <br />Mail Address <br />I�t A'�Nn � G W�I ��-t <br />State License Numbcr <br />� A-�-Lr C — <br />Proposed Use of Ciuilding <br />�„Y <br />City <br />� 1-iC-. r-�uS <br />City <br />� <br />Stateilip <br />Slale/Zip <br />��a6-a � <br />� o �� �-i33 <br />Phone <br />Phone <br />witi `1�7�_ <br />State2ip Phone <br />� S�� ' <br />Conlracl Price o( Work <br />Contact Person (Plan Review) <br />Description oi Work lo Be Done: /��l�.1 (c �%V-C. �C,�� ZC� n �c +L� eC'... <br />J Civ ' i(�c:.'"7 7 [ o c� � R�'! � J. <br />NOTE: �VIRING IN NON-DWELLINGS IS f2EQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cmiily thaf 1 have read and examineA fhis �pplicafion and know fhe sarne to be tnre and <br />conecL All provisions ollaws and ordinances �o��ernutg this type ol�vork tvill be completed <br />whefher specilied herein or not. The granfing oIa pernut does nof piesume to give authority to <br />violafe or cancel the provisions of any other sfate or local lasv regulatiny consGuc6on or the <br />perlormance o/cons6uc6on. That 1 am aulhorized by the o�vner ol this property lo perform the <br />work lor which �qplicafion is made and I cornply wilh fhe Slate Con(racfas Law 18.27 RCW and <br />Q�`Z�' U� <br />FEE <br />�0�o8--i3z <br />