Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 4"15-257-8857 — www.everetiwa org <br />APPLICATIONS ARE ACCEPT[D FROM 8 AM TO 4 PM <br />5 y/(i KC��LrLZLc-X� /�v,G <br />PROJECT ADDRESS <br />��V i v1� ��(,'( %S C �� � � L1 .S ��/i �C< ,%—' ��.lCEE1 S.' �,�: �G�d��t�� � ��� <br />Owner Mail Address C�ty SlalelZip /.2J Phone <br />T -SSC-- %3/� <br />Tenanl <br />Mail Address <br />City <br />SIatMZip Phone <br />L/ivf'c�v �r��-� c r/«� / �.3's��� i✓E /� eO�tfiav Gtifi `l'd'Qt Y� y?i -f`SJ 27d'i <br />Electrical ConUaCtor Mail Address City Slate2ip Phone <br />G��i�czz�ia�: �zr�; <br />State License Number <br />Proposed Use of Buildinc� <br />s <br />Description of Work lo Be Done: ��/= �l'H � c GN�V�Llly�i /Cx-t� <br />NOTE: WIRING IN NON DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS. MC OR AC CABLE. <br />CI7Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />-i ��. � i ) <br />Contracl Price of Work <br />Contact Person (Plan Review) <br />I hereby certdy thaf I have read and examined fhis application and know fhe same fo be true and <br />correcL Flll provisions ��l laws and ordinances governmg tAis type o/ work will be completed <br />whefher spea/ied hemin or not The granting ol a pennrt Aoes nof resume to give aufhority to <br />violafe or cancel lhe provisions ol any other stafe or local law reyuPhng constniction or fhe <br />performance o/ cons�n�cfion. That 1 am aufhonzed by (he owner o/ fhis propeRy fo pedomi fhe <br />work lor which applica(ion is made and 1 comply with the Stafe Contractors Law 1827 RCN' and <br />29G.200 WAC. <br />_ � �, <br />/, � <br />.;�i��% y y� n�— <br />Siynature � Da c <br />FEE <br />�c�SC��i-�r�s. <br />