Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY OF EVER�TT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 9820 i <br />425-257-8810 - FAX 425-257-8857 - www.everett�va.org 1-�O -�` � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM c O�O I-bS� <br />a6 i �, r� ", �-� ; _ _, �� ; �,,_- <br />PROJEc:T ADDRESS <br />,� � <br />-� ��_ C Ar3 yl� ,vor �,� /? ve <br />Owner Mail Address <br />� <br />� .� 1 <br />fC,-,,:,f �Jd,;,�,t,Z�l�v J <br />!� vc�zr—� w,� tis2��l yzi-b>G-7 <br />Cily State2ip Phone <br />/1.�,:.r� �� 26!7 2,��� e{f�/c� �i,�e Evc�e7`f �,✓/� 5� �u f vzs- zq�-2�`; <br />Tenant hlail hddress Cily State/Zip Phone <br />Eleclrical CoNraclor Afail Address <br />Stale License Numbcr <br />ProposeJ Use af Building <br />ZF �l�i e ��P i-C� <br />Description o( Work W Be Done� � i� i <br />NOTE: \NIRING IN NON-D4VELLINGS IS REQUIRED TO <br />BE IN RACE\NAYS, MC OR AC CABLE. <br />Cdy <br />State/Zip <br />f�ar-li �llJ <br />Contract Price o( Work <br />Contact Person (Plan Re�ie�v) <br />CITY OF EVERETT LOCA� SALES TAX CODE IS 3105 <br />I heiebvi certd}� fhnt 1 hav�� rcnd anii er, minad Ihis app6ca(%nn and kno�r fhe same: te be tn�e and <br />conccl: All proe�siens ollaws rand ordinances goverNng this fype o! �mrk wdl be complefed <br />�ro�hefher specilied herein or not The c�ranfing ol a pernut does not nesunte fo give aufhority fo <br />violate ar cancel ihe provisions ol any other state or local la�v regul3ting consfruction or the <br />performance ol construcGon. Thaf I am authorized by the o�vner o(Ihis property 10 perform fhe <br />�vork /or n�hich applicafion is made anA 1 cornply �vith (he State Con6actors La�v 7827 RCW and <br />296.200 INAC. <br />^ I <br />>. ` �� � <br />FEE <br />�- Gy0/- C 5 cY� <br />Phcnr <br />