Laserfiche WebLink
� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EV��RETT PERMIT SERVICES <br />3200 CEDAR STRI=ET, EVERETT, WA 98201 <br />425-257-8810 - FAX 4?_5-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�I1 v �i�f�,r�'�L�. <br />PROJECT ADDRESS <br />Owncr <br />Tenant <br />Maii Address <br />� 7 6• w^-L <br />Mail Address <br />Cily <br />Cily <br />Stale/Zlp <br />Stale2ip <br />6 - �' ��1 <br />C' liob-v�� <br />Phone <br />Phone <br />�1Z5 <br />Su rn ��1�i E�c,i�1'--� � �� 1 c i"l61>fi `��' r� W`7fl r.� L, +�� c�iA G'�s2`� i, 3r�� 5�5 ) <br />Eledrical Conlractor Mail Address Cily State/Zip Phone <br />�,tr,��,il= � ia�:� K"�. <br />Slale Licenso Number <br />�r ��A K ��A< i(� <br />Proposed Use ol Buildinc� <br />/5 �� <br />Conhacl Price of Work <br />Contacl Person (Plan Review) <br />DescripllonofWorkloOoDone: �i�� ��..��'� '�C=�:�'�" �!� �%� �:�"1�� U��l—l�i.rf, (.11�Ij�� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUlr2ED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that 1 have read and examined Ihis npplicafion and Wiou� fhe sarne fo Go Irue and <br />correcf. All provisions cl laws and ordinances gove�rung fhis typo ol �rork will be completed <br />whether specified hercin er not Tho r�ranfinr� o/ a penmt Aoes no1 preswno to c�ive authonty to <br />violafe or cancel the provisions o�any otl�er state orlocal law re�u/afing consVuction or fhe <br />periorntance o! construcfion. That 1 am aulhorized 6y the o�t�ner o/ this propedy fo perfomi Ihe <br />�vork lor �rhich application is made and I comply n�ifh Ihe State Confrac(ors Lo�v 18.27 RCIN and <br />296.200 l4�AC. <br />5-31�11 <br />FEE <br />� i l l>i� -C„C S <br />