Laserfiche WebLink
ELECTRICAL PERMIT i'•�►PPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � `g-67 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everethva.org �0766' �� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> I � ycq � q�`` b�}--U � S � � <br /> PROJECT ADDRESS <br /> �ev�v�! �vde� <br /> �i ��`fJ �.ves� u ,��o,P �12�' a'z?ss <br /> Owner Mail ddress ,,/�y City - Slale2ip Phone <br /> .-,e- 1�y l'7 <br /> � U✓�"� �5 I(�'o �Q�1'�!/L�.���. `�fiC'e+e /� <br /> Tenant hlailAd��` �,,,t�s� City £latn2ip Phone <br /> � !` . �c76n/ ��/�w✓ �v�- 12 vd <br /> [lec rical Conlractor Mail Addre City StateRip Phone <br /> Sl'�j`y � � �G C� 7 C� �,� �.S't�, t� t� <br /> State�e Number Contract Pnce of Work <br /> /�G�'i �G �►�1 �M��l ar? <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description of Work to F3e Done: �� 5�� C� � ���N G�i �O � � �� ��� <br /> ��Lu*q S �c►�tg • <br /> NOTE: WIRING IN NON-DW�'_LINGS 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 cerii(}�lhaf I have read and examined this appliwfion and know the same fo be true and <br /> correct. All provisions o(laws and ordinances yovemmg this fype of work will be comp/eted <br /> whefher spec�fied herein or noL The granfing o(a permd does not presume to give authonty fo <br /> violafe or cance/�he provisions of any other stafe or local faw regulating construction or the <br /> per(ormance ol construct�on. That 1 am authonzed by the owner of this propedy to per/om.�Ihe <br /> work(or which application is made and 1 comply with the Sfate Confractors Law 18.27 RCW and <br /> 296.200 LVAC. <br /> � '�.7 � 0 <br /> Signature Date f � � <br /> ���� <br />