Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 /�a 6-07 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org � Q 6 12 --���0 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />% �/l�� l,C� /?�ic�Ki /�' c <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />//�-cJ �—�L� <br />Eleclrical Contraclor <br />Stale License Number <br />� , <br />5��� <br />Proposed Use of Duilding <br />Mail Address <br />Mail Address <br />Mail Address <br />Cily <br />Cily <br />Cily <br />Descriplion of Work to Be Done: ���j n{' h-��/%� u��/' <br />NOTE: W IRING IN NON-DW ELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hmeb}� certily (hnt 1 have read and ext�mined fhis applic� <br />co�rect. All prov�sions ollaws and oniinances governmg <br />whether speci6ed hcrein or noL The c�rantin� oI a permd <br />violma or cancel fhe provisions ol any olher stafe or/ocal <br />� o�k %r whichra ��I'icnt or��'s n a'de and I cor10 �iedt�i}fhe� <br />29G.200 N'AC. �� �y <br />know the <br />ol�rork w <br />Stale/Zip <br />Slate/Zip <br />SWIe/Zfp <br />Contracl Price of Work <br />Contact Person (Plan Review) <br />� to be true and <br />cornpleted <br />�e authonty to <br />�ion or the <br />o perform the <br />3.27 RCW and <br />FEE <br />, <br />_ � , 1 <br />`-- ". I _ _ � j�G�/�"�J � I � � <br />_—SignaNre Dale <br />Phone <br />Phone <br />Phone <br />