Laserfiche WebLink
i <br /> 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 /> APPIICATIONS ARE ACCEPTED Fh'OM 8 AM TO 4 PM <br /> 1'_�G� �3'�2a� `i: <br /> PROJECT ADDRESS <br /> � �/o?�' � <br /> ,�, G <br /> Owner � Mail Address Ciry � SWtclZip Phane <br /> Tenant � Mail Address City Statel7Jp Phone � <br /> 3� <br /> �,e r�;,� E,�r��s� �.� /�� � /�3a `7�.� Gi/� �a� �.���� <br /> Eleclrical Conhador fdail Ad9ress City Sla e1Zip Phone <br /> it"//��UZ�rG /`�/ t 1 � �� <br /> State License Number Contract rice ot Work <br /> �Sf=,� ��z���,�.�,.. <br /> Proposed Use of Buitding Contact Person (Plan Revlew) <br /> DescriptionofWorktoBeDone: ���0 �/.C��C�".f'e //DiI)t�Y.Y�' <br /> — <br /> NOTE: WIRING IN NON•pWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC UR AC CABLE:. <br /> I <br /> �:ITY Of,EVERETT LOCAL SALES TAX CODE IS:)105 <br /> I fiereby certify that I heve read and examined thJs applicatlon and know tbe same to be true and <br /> cor�ect. All provisions ollaws and ordinar•,ces go��erning Ihis type of work wil!be completed <br /> whether speci(red herein or.nof. The granting of a partnd does not presume fo give authority to <br /> wolate or cancel the provis�ons of any other state orlceaf law regula0ng conshuction or fhe <br /> perlormance oI cons6uclion. The!1 em authorized ty fhe owner o(fhis property to pe�form the <br /> wak(or which application is made and!compty witl�the Sfate Contractors Law ib.27 RCW and <br /> 296.200 WAC. <br /> /����.��� - � /o ��_ �� '/ <br /> � gign re Dale / � <br /> �J <br /> � ����� /� � <br /> 'li C.�Sc� �='fi__`�� ' � ` / L�/� / �� <br /> [ 'd 4ESBE5909E o�Jz��i3 u�t��ki dLS � iO SO bZ ��0 <br />