Laserfiche WebLink
; <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 P1A - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> �__l � <br /> �=�r_ ��� -Z� ���. f i�,�.=� ��—_U '+'�, �(;.'�'�:i <br /> PROJECT ADDRESS <br /> ����• (��-1P��� l�l�t' 1�.1 �, ��t– A.z :`�' �n���nwv���� �'A � �k7_��(c U��;-,Sb� GyyS <br /> Owner Mail Address City State/Zip Phone <br /> �rof�./ �Cr,�a v��.G '��liV l ',�•J( <.i ( t1C�ir'\�� l,l)�.���ZGI �11.�-21•l' ICC(-, <br /> Tenanl � Mail Pddress City Stale/Zip Phone <br /> - 1 r <br /> � <br /> �\��-�ir� i <<`iv�._ �n _ Pc �-< v l�y ' �n0��a-��. . ��� C��l � ' ��11...�_ZS��-, <br /> ElectricalConVaclor A4ailAddress City Stale/Zip Phone <br /> 1 w_ t � �.�% �i=i �,n�-t ry,.�_ •`c <br /> State License Number Conlracl Price of Work <br /> m,ur�y�«� �;?�- r-�S-z�,ov <br /> Proposed Use of Building Contact Person (Plan Review) <br /> DescriptionotWorktoBeDone: _!''�:,air,: ,: r'� �_ :_�-� '�[ ��'�-� `.�x��.�� � � <br /> ) <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC C.48LE. <br /> CITY OF EVERETT LOCA�SALES TAX COOE IS 3105 <br /> I hereby ceRily that 1 have read and examined this application and know the same to be true and <br /> correct. All p,ovisions ol laws and ordinances governiny fhis type of work will be cornp/etad <br /> whether specrhad herein or noL The granting o!a permrt does not presume to give authonty to <br /> violate or cance.�!he provisions olany other state or local law regulating construction or the <br /> performance o(construction. That I am authorized by the owner o/th�s p�operty to pe�form the <br /> wak/or which application is made and 1 comply wi(h the State Confractors Law 18.2i RCW and <br /> 296.200 4VAC. <br /> C�l�-l'�.���,f�,�, ����f - <br /> Signalure ` Date <br /> L l�`ic,� -C Z� <br />