Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY vF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�P� ��b � � L �`� I i��� C <br />� � <br />PROJECT ADDRESS <br />��� �� �� I�-�'7'-�-��=� _ <br />Owner Mail Address Ciry State/Zip Phone <br />Tenant <br />Electrical <br />r�,fr, l(� �a•i(_�. <br />Stale License Number <br />�,�" F- <br />Proposed Use of Building <br />Mail Address <br />A1ail Address <br />Cily <br />Cily <br />Stale/Zip <br />Slate/Zip <br />Conlract Price o( Work <br />Conlact Person (Plan Review) <br />Descriplion of Work to Be Done: c_J ��C �VC'"J 5� f`� ��(J r�rn� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 here6y certi(y fhat 1 have read and examined this application and know the sarne fo 6e Uue and <br />correct. All provisions olla�vs and ordinances governmg this type o( work will be comp/efed <br />whether specd�ed herein ornoL The granfing o/ a pennrt does not presume fo give aulhordy lo <br />viulale or cancel fhe provisions ol any olher stafe or local law regulating construchon or fhe <br />performance o( consl�uction. Thaf 1 arn aufhoiized by fhe o�rner ol this property ro perfonn the <br />�vork lor �vhich application is made and I comply wifh the Sfate Contractors La�v 18.?7 RCW and <br />296.200 WAC. <br />� �-_, �.-- I 2- I`� �Q�, <br />Signature Date <br />FEE <br />Phone <br />Phone <br />+� �r 1 <br />�-��l <br />