Laserfiche WebLink
FROM :GUARDIPN SECURITY FAX N0. : Mdy. 30 200B 01:52FM P2 <br /> ELECTRICAL PERMIT APPLIC�'.TION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDnR STREET, EVERETT, WA 98201 <br /> 425-257-8810 • FAX425•257-8857--www.everethva.crg <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �ioa SM,,-�-� A.�- . <br /> PROJECT ADDRESS <br /> �d-l.. SaDr�S �lOa. �►'`n�rt-�n (�l�—�iP�-1-� �V�_�iS�D( <br /> O�me� � A1ail ACdrecs Cily Slate2ip T Phone <br /> Yenant �fallAtldrese Ci:y SwtefLF Phone <br /> C�1Cu-d�n� �c�)r��4�1 �tems I-1�-l3 l5t P�.S . ��iL{��.�8i3y <br /> Elecidcal Contractor A�all Addr ss C�ry S�ate/Zip aho�a <br /> �uA�Ss���t�5 � I yIR. C� <br /> Stale License Num6er Contract Price o1 Work <br /> Proposetl Use of Ouiitling u Contact Person (Plan Review) <br /> DescnpfionoiN'orkto6eDone�. �VW VORKGe. S�WrI� S��\L+� � <br /> NOTE: WIRING IN NON-DWELLINGS IS R[QUiFED TO FEE <br /> BE IN RACEWAYS,MC OF AC CABLE. <br /> CITY OF EVERBTT LOCAL SALES TNC CODE IS 3105 <br /> �nereny certi�y raa!i r,aoe read zno e��aminad rh�s application�nd know tha samo to 69 true and <br /> correcC Aif provisrons ol raws antl ord�nanr,as covcrnmg this ryps ol«nrk�mll be complvtsd <br /> v.�0ether spec�hed heiein or roL Tl:e�reming ol a permn does nct��esv,r,a tc give au(hor,tylo <br /> viclate or C;nc�l(h2 prcv;sions el any olber s!ata or lo^s�lav,�regulatina ccn;Wciion or f�e <br /> per!ormance o construcfron. That 1 am authcriz=d by t6e or�ner ol fhis propeRy fo perlorm fhe <br /> ao�k/er�vh�ch e,^plica6on;s �aiade 3ntl I Cc�rnp!y w;ui fhE S2le Ctn:ractcrs Law 78.27 RCW antl <br /> 295.2G0 V✓AC. <br /> J �U <br /> Slgnflwre � Date <br /> �v�U5 1�� <br /> � <br />