Laserfiche WebLink
I <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES C <br />3200 CEDAR STREET, EVERETT, WA 98201 6, —6 0 J <br />425-257-6810 - FAX 425.257-8857 — www.everettwa.org C 050 6-039 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />`1�T N�CLJ�-tL Sf <br />PROJECT ADDRESS <br />�/ 11U4S /iAr�� lc� �clo� �Yo4fo9- �fl�� <br />Mt I <br />Ownerrdsll Address City Slate(Lp Phone <br />'n <br />Y t //q <br />Tonant Mail Address City SlataltlP Phore-- <br />I � ya55�z <br />l-Af�I1J Z I=IPCflyc-`.3ERl /C Ll� ��� ,. &� IJA, 9860S 1-7r i <br />Electrical Contractor Mad Address City Staler? io Phone <br />fir <br />State License Number Contract Price of Work <br />L <br />Proposed Use c uildin p J� Contact Person (Plan Review) <br />Description of Work to Be Done. <br />.LYUu C �� Z0 i cP�' c cc C1n t r`i✓ <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 hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions o/laws and ordinances governing this typo or work wdl be completed <br />whether specified herein or not. The granting of a perma does not resume to give authority to <br />violate or cancel the pprovisions of any other state or local law reguPaling construction or the <br />perfarmance of censlluction. That I am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 78.27 RCW and <br />296.200 WAGDate <br />Signature — <br />Z bLn <br />zo 3Tvd 0R10313 830NVI 00t01 S00Z/90/90 <br />