Laserfiche WebLink
EILECTRICAL PERMIT APPLICA�ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 !—'�u'� <br /> 425-257-8810 - FAX425-257-8657—www.everettwa.org C��O/�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> r� � C� � �J CiJri^ 'S D 4iC<� U ! t�c� �!A ,.{'C „ Q �- <br /> !' <br /> PROJECTADDRESS <br /> `F�5 -��y- 3�. <br /> 1 �"�n�,�:yr h <br /> 1 r��.. ►7c✓���tt�!" LlL 1�5��5 �l/t:� .Sr�.n�,.,� �sJ� �c/-,-i, Lt,�l� �f��7 <br /> �. <br /> Owner Mail Address Ciry State2ip Phone <br /> Tenant MailAddmss City State2ip Phone <br /> C—'�U' S �l�fii.�� l .�J ��l li"it'_ "`�� 1' IF7M /hY� �rfl ����.�17.1� 3t�S� �i�7_3 7�fi <br /> EleclriCalContractor MailAdd�ess City Slate/Zip Phone <br /> <-�,� � -r �5 N �i 3:, R k ���.� "" <br /> Sta�e License Number Coniract Prie:o(Work <br /> � .��� Qrrtic M� *�uur,n <br /> Proposed Use ol Building Contad Person (Plan Review) <br /> Description of Work�o De Done: �C�v <.�� �ht-Y�me �T'�� <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CNBLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby cer7rly that 1 havo read and examined this appliwtion and kno�x Ihe samo fo be fruo and <br /> conect. All provisions o/laws and o�dinances govemmg fhis typo ol work will be completed <br /> whether specdied herein or noL The granting o/a pennit does not resume to give aufhonty fo <br /> violate or cancel the provisions o/anV ofher sfaf�or local law reguPhng consWclion or the - ,-,- � � <br /> peifomiance o�construc6on. Thal l am aufhonzed by tbe owner ol thisp ropeRy lo perform Ihe �� t ,j� �� <br /> a�ork)or which application is made and 1 comply wifh fhe Sfafe Confractors Law 78.27 RCW and <br /> 296.200 WAC. <br /> � r�.-�.r.� ����_�.,� r -� �- ��, <br /> Signalure `-- Date <br />