Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200CEDARSTREET, EVERFTT, WA98201 �7—I �j—�D <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org r��G �`d�l <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ����/: �.��("��'l�li�%N �1�C <br /> PROJECT ADDRESS <br /> < < <br /> ci« � �e�l<��,�� ����� ('�c� h5�� / �ru�{-f� l,l��l ��3Z��� ��.� g�;��� <br /> Owner Mall Address Ciry State2lp Phone <br /> /('f�'V7��'- r� <br /> Tonant A1ail Addmss Ciry Stale/Zip Phona <br /> �;TC'f'/1 Z II�C�/cc� I SC(i,r,'.r�$ �U ��N�.�b C U-e r,('�� (�'/ �`1d'c76 6 Ci�.�S'S'•�'+-C? <br /> EICclric�IConlraCtof MailAddress Cily StatelZip Phone <br /> Stato Liconso Number Conlract Price of Work <br /> Proposed Use of Buildin�7 Conlact Person (Plan Review) <br /> � /� <br /> Description of Work lo Do Dono: ���7VJ' /� /� P/'S <br /> NOTL": WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CADLE. <br /> CITY OF[VERETT LOCAL SALES TAX CODE IS 3105 f <br /> 1 hereby ceitily(haf I liave read and examined(his applicntion mid know the sama to be 6uo ond t���Lr.'��� - 'C\ <br /> correct. All provisi�ns of la�vs and o�zlinnncos�avernmg fhis ty�o o/work�vill be complefed �'l.� ( <br /> �rhefher spea6ed hcrein or noL The r�rantin�oI a pernut does not presumo fo c�ive aufhonty to <br /> violateorcancel0�e provisionso/anyothersl�feorlocalla�vrec�u/otingconstrucfronorfhe <br /> perlormar,co o(conslrucfion. That I am authoiized by fhe own�r o!this property fo perfomi tho <br /> n�ork for which applicafion�uuu����depnd 1 comp/y�vifh fho Sfafe Conlracfers Law 18.27 RCW ond <br />� 29G.200 WAC. � � ��/ <br />� ;% :J� �� � y ��o <br /> Signatur Date <br />