Laserfiche WebLink
�'. ISS=�': <br />� '� <br /> S <br />� ' � ELECTRICAL PERMIT APPLICATION <br />. .ti ��. � <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE7, EVERETT, WA 98201 <br /> j '`"� 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br />�..., y._ <br />,:_. <br />� "" ' APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� <br />�$!4kj'-. <br /> S <br />�� ��:����� j �J. � `I � ;_,- �� �, � <br /> PROJECT ADDRESS <br /> Owner hiail Address Ci:y Stat^2ip Pho�c <br /> Tenanl Mail Address City Stale/Zip Phone <br /> ��ci� �� r.� 1��6 << (�c'>�/ 5��� Nr �r��'`�a.�h 1,4!/�- `l�'�d3 �y�tSl ._ ,r� <br /> ElecUical Conlrac�o� Mail Address City � SlatelZip Phone <br /> 1-�� r�'(�o����'�`�(� �3�� <br /> State License Number Contracl Price o(Work <br /> /1 �'C l�k ��{.?� <br /> Proposed Use cf Building Contacl Person (Plan Review) <br /> Description of Work lo Be Done: SB'I1'�2 'r1 e : l �S�� < <� rG CQ C�E' <br /> �/ r <br /> �' lI �� �I i /� 4/Atav! �'�Y-C11�N 1„�_Lts�! Y I�V �VI {�-eE�/ W�!/l/� f <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAI'S, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX C�' e IS 3105 <br /> 1 hereby cer7ily thaf I have read and exar, ,ed this application and know the same to be true and <br /> conect. All prov�sions ol/a�vs and ordinances govenung th�s type ol work will be complefed <br /> whether speci6ed herein ur not The g�anting oI a pernut does not resume to give authonty to <br /> violafe or cancel the provisions of any other state oi local la�v reguPtint�construc6on o�fhe <br /> perlormance ol corrstruc6on. That I am authorized by the owner o/fhis property to per(orm fhe <br /> work(or which applicafion is rnade and 1 compty with fhe Stafe Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ' �, <br /> / � � + � � <br /> P� ;�%' � %,,r%��y� lU�—S-D.� _L <br /> ;,�� �.SignaWr� Date � fl � <br /> J� �� <br /> — <br /> _ _ __.r_ <br /> �4Yi'F�LA�. _ . . ... :'�h ,. . . ..���., ., . L �.�._a . .s...e. _ . " <br />