Laserfiche WebLink
ELEC�'RIC�►L PERMIT APPLICATION <br /> CITY OF EV'ERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT�, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everetbNa.org <br /> APPLICATIONS ARE ACCEPTED FkOM 8 AM TO 4 PM <br /> y2�! `/ L .{.�, S� s r'= L�' i I 8 <br /> PROJECT ADDRESS <br /> �� : � S � <br /> � _ 7 OWner P,1zil Address City Stafe/Zip Phone <br /> � .e' . <br />'rI' +,��„i <br /> Tenanl Mail Address Ciry State/Zip Phone <br /> Ileu �.� � ,�� ( E��c ��6 �>� 33 � - 7.i � 'Z <br /> Electrical Conlraclor Mail Address Cit�� State/Zip Phone <br /> VP U� �1 i��C �`i / ^i c� <br /> Slate License Number Contract Price nf Work <br /> � <br /> ��E�� c�:'1 '�\l c, � <br /> Proposed Use of�uilding Conlacl Person IPlan Review) <br /> Description of Work to Be Done: /�i E�` ��`dte <br /> �.,, <br /> � �� <br />' J \ � NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> }f BE IN RACEWAYS, MC OR AC CABLE. <br />, ��',� <br />�.� !;���eo: <br /> ' CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> ,; <br /> -` " 1 hereby certily fhat I have read and examined fhis applica(ion and know Ihe same to 6e true and <br /> correr,L All provisions ollaws and ordinances govermng this lype of work will be completed <br /> whefher specified herein or not The�7ranting oI a perrnd does net oresurne to give authonty fo <br /> violate or cancel the provisions o(any other stafe or local lasv regulating construction or the <br /> peAormance o/construcUon. Thaf I am airthorized by fhe ownc-rolfhi.,property to perlorm the <br /> work for which application is made and 1 compty with fhe State Confractors Law 18.27 RCW and <br /> 296.200 WAC. - <br /> /D • �' os' <br /> S' nalure Date <br /> l//� � � <br /> � <br />