Laserfiche WebLink
( <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �a _�.�yp <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 —vwvw.everettwa.org EfD � Z�� <br />APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br />103i'-� -�`1� P(uce. �Vrs� <br />PROJECT ADDRESS <br />>Gil� [x-1 I �l. <br />-iqy-Pl.W <br />Owner ' Mail Address <br />S�l�c <br />Tc: �anl Mail Address <br />jr�r�k� C���� IJ-C 154io <br />Electncal Contractor Mail Address <br />Cdy <br />City <br />�S� �V� $� �1�Y+cYYI <br />Cily <br />�T ���,� � E �q 12rz. , i2�i ��_ <br />Stale License Number <br />Gc�ra� � <br />Proposed L'�e ot duilding <br />Description of Work to 8e Done: <br />i1 <br />NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily that 1 have read and examined this applio <br />wrrecL All pro,visions o/laws and ordinances goverm„g <br />whefherspeci6ed herem ornot The granfing ola permit <br />violate or cancel the provisions o/ any ofherstate or local <br />periormance ol construction. That I am authonzed by tne <br />work (or which application is made and 1 comply with fhc <br />296.200 WAC. <br />�vn- �iS2c4 �Z�-3S3.. <br />State2ip Phone <br />SlalelZip Phone <br />Wk u�CL�1b 3ic�-(�b�(- <br />Sta1e/2ip Phone <br />•2 Z�o"-' <br />Contract Price of Work <br />Contact Person (Plan Review) <br />�•: ��{1 1'i���L'.� l 11 �l �taC.�l Pl� <br />( r _. . - - — <br />and know the same to be frue and <br />ype ol work will be completed <br />nofp resume to give authonty to <br />�egulating construction or fhe <br />er o/ this property to per(orm the <br />conrracrors Law 18.27 RCW and <br />1 �-t Z't � Zo �'D <br />FEE <br />