Laserfiche WebLink
1 " <br /> 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 II—/(�_U J <br /> EUS// —OE(, <br /> () � <br /> ��� , ; <br /> PROJECT ADDRESS <br /> ;,,��._ ��' 'n_ /, i. � � � . �- ,�- ��'' .��` <br /> Owner - Mail Address City State�Zip Phone <br /> Tenant Mail Address Cily Slate2ip Phone <br /> -J�_ �_ _ ,_ -.'7 <br /> �� , ,: _��r .r_ ,� .�� ,� - �� ` � �, ' ti_�� ' _-s �:�.��./��- > ;�„� :���--;. <br /> Eleclrical Contraclor Mail AdGress Ciry State/Zip Phone <br /> i,- /���> <br /> j ��t '� . <br /> ;'l'j_.l J �' � � �':1 S� __ � � � ��` <br /> Stale License Number Conlracl Price o(Work <br /> � �� 1 - , e ,� ,. <br /> Proposed Use o(Buildin� � Contacl Person (Plan Review) <br /> Descriplion af Work lo C�c Donc: � � <br /> NOTE: �VIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> I heieby cerfi(y thef I have read and examined this application and know the sarne to be true and <br /> correcL All p�ovisions o//aws and ordinances governmg fhis fype u/�rerh �vill be completcd <br /> tvhether specdied herein or noL The granting o/a penmf does not resume to give authonty fo <br /> violafe or cancel the provisions o/any other sfate or local law reguPfing consVuction or fhe <br /> per(onnance ol consVuclion. Thaf I am authorized by the ou�ner o!(his properiy to peilonn the <br /> wo�k lor�vhich applicatien is made and I comply�vifh the Sfate Contractors Law 1827 RCl4�and <br /> 296.200 WAC. <br /> " � � ,"� L� � �� <br /> SignaWre �� . � Date <br /> / � <br /> v ���� _ C�C�� C./'' <br /> J <br />