Laserfiche WebLink
h1R1'-17-2010 06:20A FROM:DRHL ELECTP.IC-EVERET 425-252-2999 -f0:4252578857 P. 1�1 <br /> l <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 j_)'� ..,/� <br /> 425-257-6810 - FAX 425-257-8857-www.everettwa.org C/Ob 5-�6� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 38! 7�n�� r�� �vc. <br /> PROJECT ADDRESS <br /> . <br /> �oy� ��tiu��,���r� sg�� �� ���-d <br /> Ownn� M�II AdAress City Slalo/Zip Phono <br /> .Sa,,w.e_ a� ��t'� <br /> rs�sa r�� �e55 —c�-r-----��razr---��-�;a <br /> h '� l yzs - <br /> DE}KL �L�CT�2.l� ��X/l)q//�t�euu9L/��dE�✓C��P'TT Wi� 4�20/ �Z52 !?oo <br /> Electrical Contractor h7aii qddross Clty State2ip Phone <br /> D�rf��r9a� .hj D � s�• `�' <br /> Slolo Liconso Number CoNract Prico of Work <br /> Prop • Use of uilding Contact Person (Plan Roviaw) <br /> Doscriplion of Work to�o Dona: GGlti � <br /> NOTE: WIRING IN NON-DWELLINGS IS REDUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CADLE. <br /> �5 �• 5� <br /> CITY OF EVERETT LOCAL SALES TN(CODE IS J105 <br /> 1 hareby certily thaf I havo road end exendned thls epplicelion nnd know Iho samu(o be trua nnd ����`� `J�,� <br /> cor�or6 A/I prnvleionc ol/mvr ond ordinaneou go��ormny Ihio f�po o!��•orlr�vlll bo oomp/ofed V � <br /> who(horspecifind ha�eln u�noL TDu yrnnfinp o/a pnrrnd doos nof Prusume(o glve auihorlty(0 <br /> violate or cancel Iho provlslens ol eny ofhor stato or loca!lew regu/nling consfrucfion or Ihe <br /> pvrlornrnnc�o conslrucf/on. 'fhat 1 em nufhai.od by769 ownPr o/thls property fo peAorm tho <br /> work lor whic ppOcafion is do end omply wlfh fhe Stefo ConVactors Law 18.27 RCW and <br /> 2 .200 th' <br /> s�i7�o <br /> ��v�,�}�/� oeto <br /> 1/ <br />