Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERIVIIT SERVICES <br /> 3200 CEDAR STREET, EVEREIT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857-•vwtiv.cve�ettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEE�IT&CREDIT CARDS ARE NOT AC¢EPTED <br /> ��.1., : 1,��,..� ��:. :� �. 10 i � (� � . <br /> ���I��t ���� �nF`' A�� S� <br /> PROJECT ADDRESS <br /> IJ � � �' �\ � �h%u Q.C\ i��, / � G � �1 �nn�nm . S � �J.�' Gj�B 2, �3 <br /> Owner� Mail Address City StataZp Phone <br /> �.. < <� Y�l , n� <br /> Tenant Mail Address Ciry SlalelZlp .3� Phone <br /> S °122`'1 1 � E 3 <br /> `- �-cc �- . 1 � QcL. n�1n� � O ��x �-�' 3 �5 �nol��,�., 4 �„ I 331_ <br /> ElectricalContractor MailAd re Ciry Stale/7Jp Phone <br /> ��.� c� � `� � �-uN '� � z 5 �° <br /> S:ate License Number ConVact Price of Work <br /> �.�{' �� ���v � S <br /> Proposed Use of Building Contact Person (Plan Review) ; <br /> r.. <br /> ,a, <br /> � Ni., " <br /> Description of Work to Be Done: • �=C �� � o.•� �� 1 � � <br /> .�.;...,. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF FVERETT LOCAL SALES TAX CODE IS 3105 ". <br /> 1 hereby ceRi(y fhat 1 have read and examined this application and know the same to be true and <br /> conect. All provisions ollaws and ordinances governing this type of work will 6e completed <br /> whether specified herein or not The g�anting o(a permd does not presume to give authontv to <br /> violate or cancel the provisions of any other state or IocaUaw regulating construction or tha' <br /> peformance of constructio . That 1 am authorized 6y the owner o/this property to peAorm the <br /> work(r which applicatio � m�Je and 1 compty with the State Contractors Law 18.27/�C W and <br /> 296.200 WAC. / (j <br /> I 1 ��.-J'� <br /> � � zo �o�=� 7 �� ��� <br /> - Ignature , Date � , �''� � , <br /> � . ' _..� . .:,�.q, ': <br /> �y� <br /> �{w:C. <br /> �y r,�. <br /> . '. ,i.f,.>:. <br />