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.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> v�G�d � �r? ; �l� S �, <br /> PROJECT ADDRESS <br /> /�Q �rT���. �GSC�� 3pD` Sn,,� .sF LCIJ�r�l7 ���. � / <br /> Owner Mail Address City State/Zip Phone <br /> .SLf/+� � '��,S—o�.'S_p ��S� <br /> Tenant Mail Address City StateZp Phone <br /> C /�Gv 1� S �/!�. 73/ e��(/ J/� /�'W �J /l1�74�C/!J �� �vL�Z <br /> ElecNcal Contractor Mail Address Ciry StateZp Phone <br /> �L�;.,,� cz"o�l,�� � �9C�� � <br /> State License Number Contract Price of Work <br /> Q-�'S�i�'e /Slo� ��'� <br /> Proposed Use of B Iding Contact Person (Plan Review) <br /> Description of Work to Be Done: /D ( �r'� p 1'c_� �� ��0 KJ S � �0 C <br /> Sa,��`/ �v.r �p;P�. � �.� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceMify that I ha�e read and examined this application and know the same to be true and <br /> correct. All provisions o/laws and ordinances goveming this type ol work will be comple,ed <br /> whether speci(ied herein or noL The granting ol a permd does not presume fo give authonty to <br /> violate ancel the provisions ol any other state or local law regu/eting construction or the <br /> peAo an e o/construction. That I am aurhonzed by the owner ol fhis property fo pedorm the <br /> work/or w 'ch application is ma and I comply with the Sfafe Contractors Law 18.27 RCW and <br /> 296. 00 W � <br /> � f � �-� - �y <br /> Siqnawre Date <br /> �G�{C�€-Co8' <br />