Laserfiche WebLink
ELECTRICAL PERMIT APp�i��TION <br /> �ITY OF EVERETT PERMIT S�:RVICES <br /> 3200 CEDAR STREET, EVER�TT, V�'r�98201 <br /> 425-257-8810 - FAX 425-257-8857-wv-,v.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TJ 4 PM -DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> !(7D�'� Ov�C-:�� JT <br /> PROJECT ADDRESS <br /> ,�( ;' <br /> �i/l_,,�, l��_J` .l ))�.icY J f �_.✓C-L'.�:��� In�� �( (,(�7 � .S�fj-���>1l? <br /> Owner h1ail Address City State2ip Phone <br /> Tenant Mail Address Cily Slate/Zip Phono <br /> � o d, <br /> � / /- n <br /> �iC.p�i (i,.'.6�:�2��- Jl'�J���' <br /> (_S� � I �F'- �_ /, ,..���,� bin �8l_l%. .;�,>-G,3oa <br /> EleclriCal Conlractor Mail Addmss Ciry SlatelZip Phone <br /> �.O I f�� 7�� I�.�i ZOOcz�— <br /> Slale License Number CoMracl Price of Work <br /> jC.oTr �tl�-�i.� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> DescriplionofWo:ktoBeDone: K���-'�« �X-L� � �--N�/ ��`^��� -L^�T�=�'-T�� <br /> � � QLy •.�,;Jc I-� �tic.L <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> i BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � <br /> 1 hereby certily fhat 1 have read and exarnined this applicalion and know the same to be fnie ard <br /> correrL All provisir,J s of laws anA ordinances�overning this type o/work will be cornplefed I�f c � <br /> whether specdied,h vin or not The c�rar ting ol a pennd does noi presume(o give aufhonty to � W <br /> violafeorcancellhe rov,sionco/anyplf�ersfateorlocallawre�ulatingconsfruclionorBie I <br /> pen"crmance o�con �iucf�pr�/ That I am aulhonzed by Ihe owner M th�s property fo peAonn the � <br /> work/or which app(icaliad iS rnade�r±d 1 comply with the Sfafe Confracfors Law 1827 RCW and � „ <br /> 296.200 WAC.� ;� Yl�/ I <br /> r / \ <br /> /'� �/ � � <br /> ��, ��'`--� � �� �;��5_ <br /> '�� ��SipnaWre D le <br /> �p50�-[5� <br />