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 /> ?�'� ; �, `7m � i+-F /�v�: - <br /> PROJECTADDRESS <br /> 5 }�-�r�A,_ (�a �. �s��= ��-? e�t�� y�zts-'�s� �.� <br /> Owner Mail Address City State/Zip Phone <br /> TenaM Idail Address City StalelZip Phone <br /> �� <br /> �s��`- :l.l �l�C.7�j� ('S PQ • �y�lc`�-�4�7 �n `�2�� � 3`� Z�� � <br /> Eleclrical Coniractor Mail Address Ciry Stale2ip Phons <br /> �y. �--�-�._� <br /> (� (�l�-���>C1� t"��i 7 r `-' �L�'�'� '- <br /> Stale License Number Contracl Price of Work <br /> L��i.l� � �a�—I �`�- <br /> Proposed Use of Buil ing Contact Person (Plan Review) <br /> Square Footage Qf residenli�l nev✓construction, mmodel or addi�ion) <br /> Description of Work lo�e Done: / V�'w )2-� /�m P ��-�► �� <br /> I����� <br /> NOTE' WIRING IN NON-DWELLINGS IS REQUIR[D TO FEE <br /> � B[ IN RACEWAYS, MC OR AC CABLE. �� . �� <br /> CITY OF EVERETT 1 OCAL SALES TAX CODE IS 3105 <br /> I hemby ceriily Ihaf 1 have mad and examined lhis applicafion and kno�v the same to be true and <br /> correcG All pruvisions o//a�vs and o�dinances govcming Ihis type ol work will be completed <br /> �•,ltefherspec�(ed herrin ontoL The gran(ing oI a pemut does nof prLsume tn give aufhonty lo <br /> violate or cancel(/ie pior�sions o(any ofher state or local Imv myulafing consfruction or tl�^ <br /> peAommnce o(constivcuar. That l;�m aufhorized Gy lhe owner o/this�roperty to pedonn fhe <br /> work for�vhich appli�afion is made and 1 compty�a�ilh the State Confractors Law 18.27 RCW and <br /> 296.200 WaC. � <br /> C/ �L_ /��� /� � _ <br /> Signature Dai� <br />