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 `a3_�g <br /> ���o9-i3 �- <br /> ` , <br /> PROJECT ADDRESS <br /> ��. <br /> . - � . � . � .� . . � ,( � . - � <br />� °''�'��!' Owner MailAddress City Stale/Zip Plione <br /> If''�x�?,��;'�, <br /> - ���i TOnanl M1tail Address City State/Zip Phone <br /> , y� <br /> .� � � � . �� . :I . /,�; i � =i14CC .. � . �6i-:r=. ' r . ,f�J ��"r7S' . �-��.;c�i� •J „: ' � . <br /> Eler,lrical Contraclor Mail Address City Stale/Zip Vhone <br /> , ��� � i�) <br /> - �,"� ' � il� � 'l i. �'. --- <br /> l; <br /> Slale License Number Conlract Price of Work <br /> ProposeG Use of Buildinc� Contact Person (Plan Review) <br /> Descriplion of Work to Bo Done: ___ � i:,: i % ` <br /> �, ; i ; i�� ', �. i r <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> ' 1 heieby certily fhst 1 have read and examined this ap�lica(ion and know Ihe same fo be true and <br /> correcL All provisions o(la�vs and ordrnances governuig fhis type ol work iti�ill be comp/eted <br /> �thefher speciGed herein or noL The grantrn�of a penmt does not �resume to give aufhonty fo <br /> violate or cancel fhe pr:�visions olany other stafe or local la�v regulafing constn�ction orthe <br /> per�or,nance o(construction. That I am aufhonzed Uy fhe o�tiner o/this property to pen,mi Ihe <br /> �vork lur which applicatior is mada and 1 cornply with the S!ate Contractors Law 18.27I2CW and <br /> 296.200 WAC. <br /> , <br /> SignaWre - Date <br /> Ea��u9-i3a � <br /> -- ---- -- --------- � <br />