Laserfiche WebLink
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 - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> j�fC�z c��,�r�i��'o/'� <br /> PROJECT ADDRESS <br /> ( �IG� 1 �'Oi= %`I�,S LO� �>';" ,4�c' L��'c'/'��l% G✓/� % �D'% `�.7�'Yy�i T <br /> Owner Mail Address City Slate2ip Phone <br /> Tenant Mail Address City State2ip Phono <br /> Eleclricat Conlraclor Mail AJdress City State2ip Phone <br /> State License Number Contrect Price of Wbrk <br /> /(�'S%1��h�L�r <br /> Proposed Use of Buildinc� Contact Person (Plan Review) <br /> %!�C"/,'•).'-�.� 1 r�/'6 C � ;"u"'i /!; /n ;?L? <br /> Description of Work to Bc Done: � j (�� <br /> NOTE: W IRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � <br /> S <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cedily Ihat 1 have read and examined this applicafion and know fhe same fo be(n�e and <br /> correcf. All piovisions o/laws and ordinances governing fhis fype o/work will Ge comp/efed <br /> whether speaGed herein or not The granfing o/a penmt does not resurne to give aidhonty fo <br /> violate or cancel the provisions ol any other sfafe or local law reguPting consfniction or the <br /> pedomtance o/construction. That I am authorize,i by fhe awner o/this property fo perlorm the <br /> work(or which appliwfion is nwde anA 1 comply with fhe Sfata Contractors Law 1 B27 RCW and <br /> 296.200 WAC. <br /> .; <br /> _ - . - <br /> i <br /> ���—_'— --�r" J l )�� � L�.S <br /> ��ignature • Dale <br /> ✓ <br /> �� -��' <br />