Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERE"fT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9d201 <br /> 4G5-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICA'i IONS ARE ACCEPTEr FROM 8 AM TO 4 PM <br /> d- <br /> / O �3��. / % <br /> PROJECT ADDRESS ! <br /> / / / II <br /> Owner Mail Address Cily State/Zip Phone I <br /> --���--,—/, �� � � <br /> Tenan/t � ��-� � MailAddress Cily Stale/Zip Phone <br /> Electrica/I C t acto� Mail Address City State/Zip Phone <br /> State License Number Conlracl Price of Work <br /> Proposed Use of Building , / � Conlact Person (Plan Review) <br /> ��� �` �� S � � O� S� / <br /> Description o(Work to Be Done: _ �/ia-�� / � �—_ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify Ihat 1 have read and examined Ihis application and know the same to be frue and <br /> correct All provisions of laws and ordinances governmg th�s type oI work will be completed <br /> whefher specified herein or noC The g�anting o/a permit does nof presume to give aufhonty to <br /> violafe or cancel Ihe�rovisions o/any other stafe or local law regulating consfrucGon or the <br /> pedonnance oI consfrucfion. That I am authorized by the owner o�fh�s property fo perform the <br /> work lor which application is made and 1 comply with the Stafe Contractors Law 18.27 kCW and <br /> 296.200 WAC. <br /> SignaWrc Dale <br /> �r- i9_ a-a�s 50��1 l <br /> � <br />