Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF' EVERETT PERMIT SERVICES <br /> 3200 r_.EDAR STREET, EVERETT, WA 98201 <br /> 425-257-8t3?0 - FAX 425-257-8857 --www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � L� ,� �,V (� : 2� ,( c N �v�2E� fi(/l�t <br /> PROJECT ADDRESS <br /> _C R U S-�-A � SA�� <br /> Owner Mail Adtlress City State/Zip Phone <br /> Tenanl Mail Address City Slale/Zip Phone <br /> �r.s��dX'yS ��E-iT l.ti( ����� �z7o � ,�, /s Cc�,¢ <br /> , <br /> Eleclrical Coniracbr Mail Address City Stale/Zip Pnone <br /> � i/Mt�/Jt=T�p�,T I �o c��— <br /> Slate Li ense Number �-- Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description ot Work lo De Done: (� U�-y�ij��/�'� �� �� � ��� <br /> c <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certilv fhaf 1 have read and examined this application and hnow the same to 6e We and <br /> correct. All pPovisions o(/aws and ordinances governing this type olwork will be completed <br /> whefher speci/ied herein or noL The granling ol a permd does nol presurne to give authonty to <br /> violafe or cancel Ore provisions oI any other slafe or local law regulafing construction or fhe <br /> peAormmice olconstruction. a(I arn au0iorizcAby the owner ol th�s property fo perform the <br /> work lor�vhich application is 'ta e and omply wi(h fHe State Contracfors Law f8.27 RCW and <br /> 296.2001NAC. f <br /> Z— � � C.� � <br /> Si ature Date <br /> . �� '�� <br /> � / � / <br /> / ll� <br />