Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <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 <br />l�,z� cti1. ���k;l��� �1��� <br />PROJECTADDRESS <br />� <br />Tenant <br />Meil Address <br />Mall Addrass <br />'c^ l �/�CtrrC � <br />COnlraclor MailAddress <br />EKP� � E lOC�:� �r <br />State Licence Number <br />(.�i� S! �. <br />Proposed Use of Building <br />Desaiplion of Work lo Be Done: <br />"�� �U�l� ✓ <br />I R������.,�� Gu'/� �'Xc �7�� <br />City Stata/Zip <br />City St�tle/Zip <br />Ciry <br />Phonr <br />Phone <br />StntefZip Phone <br />.��C� S�-o �C� <br />Co tract Pnce of W rk <br />i�en c3a�i.-�9 <br />7 s � ;rc S- �){�.'3 [� <br />Contact Person (Plan Review) <br />� <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 />1 hereby ceqily �haf 1 have rend and examined fhis applicafion and knowlhe snme to be frue and <br />conecf. All pmvisions o(laws end nrdmances govemmg this type o! work will be complefed <br />whefher speci(ed herein o� noL The granfing o/ a pennd does nof prosume fo give authonry to <br />violale or cancal fhe provisions o/ any ofher stafe or local law reyulnting constnic6on or the <br />perfomiance oI construcfion. Thaf 1 am aulhonzed by Ihe owner ollhis pinperty fo peAorm Ihe <br />work lor whiGr applicafion is made and 1 comply wNh thQ Sfate Confractors Law 7A.27 RCW and <br />296.200 W.7C. <br />Lignature` � <br />�! ,./ '7'' / <br />/V ('L'�(/ ,1i1S�c'cT;�t�cl <br />Y- /Z—� <br />FEE <br />�c c�� 1 c � i�ti�� � 7�/ 1�G' � <br />E 06c�1-ORo <br />