Laserfiche WebLink
ELECTRICAL PERMI'i APPLiCATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ��-9-0 9 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �"��!/�O� <br /> ��I � S,.n�`f►� �At1e• . Eve�r7't� wA 48201 <br /> PROJECT ADDRESS <br /> ��>�`-�; �� Eutrrifi 293o t�.�-t,�lmo✓e Ave Cue�c1-'� wA q�'�o; <br /> Ownef Mail Address City State/Zip Phona <br /> ��Qrt'H" �'1'av�$� �I� Swiit�l AJL �I�P�tT'�' w�a 99�+ <br /> Tenant Mail Address Ciry StalelZip P�one <br /> S>��t'c�c� �Icx� Z ��u'rt� d �� �Vr��st'i— l.c�/r `If�2U � �i?<'7s�-os <br /> ElecMcal CoNractor Mail Atltlress City Slate/Zip Phone <br /> ��r^ti�, SEf►COGIq �cIDC� �i�Joo <br /> State License Number CoNract Pnce of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> DescnptionofWorktoBeDone' �n��a // �U✓NryJ��Cf1�:e�5 (,lJT�:�q !'Uf/AN2rIclh <br /> .�V�f{w� . S.n.Sh+ // 14k�l.-w5 — �f'S5 �� 7�l`� (n��r1r.:T,1•�, t <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 �',I <br /> I liereby certi(y fhaf I have road and examined ths application and kno�v tho same fo be true and �u I I I '"L�j� <br /> correcl All provisions ol laws and ordinances goveming fhis typo ol work will be completed <br /> �vhether spe�d�ed herein or nof. Tho grar,ting o/a pernut does nof resume to give aufhonty fo <br /> violate or cancel the provisions of any ofher state or local law reguPfing construchon or tho <br /> perlonnance ol constn�ction. That 1 am authonzed Gy Ihe owner o/this property to peAonn(he <br /> �t-ork�or u•hich applrcafion is made and!comply�vith the Stato Contractors Law 78.27 RCW and <br /> 296.200 WAC. <br /> �� - <br /> —(�(?!� ' � /�—�l'� �7 <br /> SignaWre Dale <br />