Laserfiche WebLink
ELECTRIC�iL PERMIT APPLICp►TION <br /> CITY OF EVERETT PERMIT SERVICES 3 `� �v�� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—www.evaretiwa.org �1 ��3�0� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �j�C C�S I �v� ,S.E _ <br /> PROJECT ADDRESS <br /> i.{ 2�;, _353 - h3o <br /> \ �-� �;�,�� �-I 25- z 3�s-o r 3 i <br /> Owner <br /> Mail Address City State2ip Phone <br /> Tenanl Mail Address Cily State/Zip Phnne <br /> �-i 3� -5 7 z� <br /> �nnr�rl� I�SL� V7rc��c. I�,`�I�i O��'N�p�� [A�1'`���S;�,s u�1- �b'R3 <br /> Electrical Contractor Mail Address C�ry Slale/Zip Phone <br /> State License Number Conlract Price of Work <br /> ��f1'�C — ConlactPerson (PlanReview) <br /> Proposed Use of Buildinc� <br /> Description of Work to�e Done: �� �X `1�� �� �V-�'U' - `�r( �J • � � �c� <br /> � <br /> ���-7-�2. , , a )>��C<7=-M <br /> NOTE: WIRING IN NON-DWEI.LINGS IS REQUIRED TO FEE <br /> BE If�J RACEWAYS, MC OR AC CARLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � v S%G; <br /> i 1 hereby certily thaf 1 have read�nd examined fhis application and kno�v the same to be frue and � j 2U 5 <br /> / <br /> correcL A!1 piovisions of/a�vs and ordinances govermng ihis type o(work will be,completed <br /> whether specified herein or not The�ranfing ol a perrnit does nof prasume to gne aufhonty to <br /> violate or cancel the provisions o(any olher state or local law regulating construc6on er fhe <br /> ; performance o/construcfion. That I am aufhorizzd by the owner of this property to pederm the <br /> �rond<lor which app.;cation is rnade and I comply�vilh the S(ate Contractors La�v 18.27 RCW'and <br /> 296.200 WAC. <br /> :� ��iJ�/ Z <br /> �s-'Si;7n,,fure � Date <br />