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 <br />_� (�Z Lti��� �J�-o��J <br />PROJECT ADDRESS <br />��f I1 .1I 1-+- <br />E T� l�i n�'llld ,vV h! f L �' � W 1Un� %� v�✓e �� �� � <br />Owner <br />Tenanl <br />v �� ; }'� IC'-✓ <br />Elecirical CoMredor <br />State License Number <br />. � <br />� �'',C5 % <br />Proposed Use of Building <br />Mail Address <br />Mail Addiess <br />A1ail Address <br />Descriplion of Work to Bo Done: �� <br />�� � jfvr��, ICG ✓ <br />City <br />City <br />City <br />SW�e2ip <br />State2ip <br />Stale2ip <br />Conlract Price of Work <br />'?-�J I <br />9��� <br />Contact Person (Plan Review) <br />/� i r <br />�,,5 p I uc IL l'�o �ti E I I L.` <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />I3E IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereb}� certily O�at I have read and examined (his applic <br />co�raU. AIf provisions olla�vs and ordinances govenung <br />�vhether specr(ied herein or noL The granting o/ a pernuf <br />violale or cancel fhe provisions olany other state orloca� <br />�eork lor lt��hichta ��l cta�fior � s r�rdo ar�id I aononzevitl ytheE <br />296.200�qVAC. �� Py <br />/ <br />`�''�.i� l, /�'��°1;' <br />l / .� '✓ liV � <br />y � Signature' � <br />�, <br />and know ffie <br />vne ol work w <br />la�v <br />��a <br />� to be Iruo and <br />complefed <br />re authonty to <br />tion orthe <br />o perfomi fhe <br />8.27 RCW and <br />FEE <br />���I /;'—. <br />�as �- <br />Phone <br />Phone <br />Phone <br />