Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVER�TT PERMIT SERVIC�S <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everethva.org / Z '"� �—�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � o �7�z - �9� <br /> � � '� �� �-1-1�lL-��. ���i,'� <br /> PROJECT ADDRESS <br /> O�vner 61a�1 ndoicss City State2ip Phone <br /> Tenanl Mail Address Ciry SWIe/Zip Phone <br /> �l�� ���Pt-fZt'(� �Za� j c�" c� S� L=l/ �.cl��- `��s —Z�� `t z5 -35� — <br /> [lectrical Conlraclor nlail Address Ciry Siateilip Pl,mie�o <br /> W� <br /> �°�Lt�i ��t�zt l��" .3��d ., <br /> StaL• License Numbcr Conlracl Price of Work <br /> �;�i.,1�o �> <br /> Proposed Usc of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: _��: �� � ' �( �L � lJ�lv�E� r LO� LN�'��C - <br /> �• � 1���tnJ Cratil >i <br /> NOTE: WIRING IN NON-DWELLINGS IS RGQUIRED TO FEE <br /> BE IN RACEWAYS, �1C OR AC CABLE. <br /> CITY OF EVERETT LOCAL SAIES TAX CODE IS 3105 <br /> 1 hereby ceRily Ihaf 1 have read and examined Ihis applir,ation and kno�v fhe same fo be Vire and <br /> con�ecL All pravisions of laws and o�dinances goveming Ihis type o(u�ork�vill be cornplefed <br /> whefher speafied herein or noL The gi�3nting of a pernnt does not �resunte fo give atdhonty to <br /> violate or cancel the provisions of any olh�r state or local la�v regu�aling construchon or fhe <br /> peAormance ol construct�on. That I artt aufhorized by the owner o/this property fo peAorm the <br /> �vork lor which application is made and I compty�rith fhe Sfafe Confractors La�v 18.27 RCW and <br /> 296.200 WAC. ; <br /> 1tL���1 � '�I' ? � � ( ? C,� �- , ' l � ,1 �, _" <br /> Signalurc � " Datc !, � <br />