Laserfiche WebLink
� <br /> E�ECTRICAL PERMIT APPLICATION <br /> C�TY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �� ` ��_O� <br /> 425-257-8810 - FAX 425-257-8857—www.everethva.org � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ���/� `�� <br /> , � ��� �l��,.� R.: �� a ��_,,,�. <br /> PROJEC7ADDRESS <br /> ��2!'- 7J <br /> � ,,� tr:�1�.�.. , ��s�c v��W 2�a�� o� l�•t.-c �, La.a `?����3 V�3r <br /> Owner Mail Address � City Stale¢ip Phone <br /> Tenanl MailAddmss Gry Slale2ip Phone <br /> cf � k. � ;,�� P� �s,� �.����� .�. �,ti �.,�+ �v�z� z�, ��y-����� <br /> Electnwl Contractor Mail Atldresx Ciry S�ate2ip Phone <br /> (QOZ �3`�3 �J1 Q 7�00' <br /> State License Number Contrad Pnce o(Work <br /> fZ��� �1,...4:N� � �r�,Zk v�nle: ll <br /> Proposed Use of Building Comacl Person (Plan Review) <br /> Description of Work�o Be Done _� � � ��^: . .� �' r� � � 1^-'-, ' �: .'�- 1 � <br /> t1rc� �- � �o�^ - <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> l <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 5105 <br /> I horoby certily fbat 1 have read end examinod Ihis applicaGon and know fho same to be frue and <br /> r.onecf. All provisions o/lews and ordinances goveming Ihis t}pe o/arork will be completed <br /> whnther spocdied beroin or nol. Tho granfing o/a pomvt Aoos nof p/esume fo give aufhonty fo <br /> viola(o or cmicel(he provisions ol any othor s(ato or local law rogulating mnslrudion or fhe <br /> porlomranco o/cons(ruction. That 1 am autlronzod 6y the owner oI fhis pmporty fo perform fhe <br /> wo�h/or whrch applicafion is made and 1 cromply wifh fho Slale Confraclors Law 7817 RCW and <br /> 296200 WAC. <br /> "� ', ' I u > > -�'t <br /> �ti. ,�. V �!_��- <br /> - — Signalure Datr, <br /> CC�qIG �1.5�' <br />