Laserfiche WebLink
70�32� � = <br /> ELECTRICAL PERMIT APPLICATIOIV <br /> CITY OF EVERETT PERMIT SERVICES 6`2�_ 07 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org ��7p 6`I'�-� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /1�t19 lq�k �1�e �,� Sfc B�o/ <br /> PROJECT ADDRESS <br /> Si G,l �c��t9 /!y/9 /�� �9�� SE S�c Blol �v�r�rf� wr��9�'za'�,�8s��az. <br /> OWnef �—MailAddress Clty StatelZip Phonc <br /> Tenanl MailAddress City Sla�c/Zip Phone <br /> }i2S <br /> �j ri�kS ��iN.l .��Gu�i�y 2l3lt ,�0��G�i S�S��/Db .�d%�� Q,+�l,/��'oZ/ yps-Yz3P <br /> ElectricalContrac!or MailAddress City StalolZip Phone <br /> ,Q/���i�' �S /��''GE �`I9 00 <br /> State License Number Contracl Price of Work <br /> cS Gl�or! ���inpv� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descrip�ion of Work to Be Done: �r `�US�d« � ` �a rM <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. 2� �O <br /> �J <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerfify that 1 have read and examined Biis applicafion and know fhe same to be true and <br /> correct All provisions o(laws and ordinances governing this type o/k�ork�vill be completed <br /> whether specilied berein or noL 7he granfing o�a permrt does nof presume fo give aufhority fo <br /> violate or cancel(he provisions o/any other state or local law regulafing consWction or fhe <br /> perlonnance of construction. That I a�,h aufhorized by fhe owner o/this property to pedorm fhe <br /> work for which applicafion is made and I comply with the Sfate Coniractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ��i� ,��,� ��°�� <br /> � ' Signaturc Date <br /> E o�cr�-�z, <br />