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 ACCEP7ED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CAftDS ARE NOT ACCEPTED <br />s�. �'-1 . <br />��Cl�� �ClO � c�-��i �,v< < 1—�'r'�� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />�� 5oS\� R���. <br />Elsctrical Contrartor Mail Address <br />�1� 9 �5 �-r <br />State License Number <br />Proposed Use of Building <br />Description of Work to Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />City <br />City <br />.S �- ri$d5is <br />SWte/Zip <br />Stale2ip <br />�� %� 9� <br />SlateRip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />I hereby certify that ! have read and examined this application and know the same to be true ar.d <br />conect. AI! provisions of /aws and ordinances governing this type o( work will be completed <br />whether specr�ed herein or noL The granting of a perm�t does not resume to give authority to <br />violate or cancel the provisions of any othe� state or /ocal law reguPting construction or the <br />performance o/ construchon. 7hat 1 am authonzed by the owner o/ this preperty fo peAorm tbe <br />woik for which application isp�de and ! comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. / l <br />FEE <br />��,a� <br />��yoy��r� <br />Phone <br />Ph�ne <br />0-90`t(, <br />Phone <br />