Laserfiche WebLink
ELECTRICAL PERM:T �4P'PLICATION <br />CITY OF EV�RETT PERMIT SERVICES <br />320L C'FDAR STREET, t\/ERETT, WA 98201 <br />425-257-8810 - FAX425-2578857—www.everettwa.or4 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />,»CIG� / -r� S� G—!�C/E // /✓Q <br />PROJ[CT ADDRESS <br />� --aa -� o <br />[—ioa 3—IIC� <br />���C�r%/l ��i-�a�r 1i✓ %�� f�v�i� � l✓A 7��0� �/ZS-15%-1.% �f j <br />Owner Mail Address City Slate/Zip Phone I <br />Tenam <br />El�ctrical Contractor <br />Mail Address <br />Mzii Address <br />�lh��� � � �%O/�/i <br />Statc License Number <br />Proposed Use of Building <br />Description of Work lo Be Done: <br />�i�.,osT ts <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEN�AYS, MC OR AC CABLE . <br />CITY OF EVERETT LOCAL SALES TAX COD[ IS 3105 <br />Z <br />City <br />�= <br />City <br />Sta�elZip <br />� 9Y2 <br />Slate2ip <br />� �99DD <br />Contract Price of Work <br />Contact Person (Plan Review) <br />FEE <br />i hereby ceRily fkat I have read and examined this applicafion and know the same to bo tn�e and <br />correcl. AI!;.�rovisions ollaws and ordinances governmg this type oI work will be complefed <br />rohether specilied herein or noL The granfing o/ a pennd does not presume lo give authority to <br />�iolale or cancel fhe p�omsions o(any otlmrslafe or local law regula!ing consVuclion or fhe <br />per/ormarce o( consfrr,cfioa Thaf 1 am authorized by fhe o�vner oI this property fo perlorm the <br />�ro�k /or �vhich application is mado and I comply wilh Ihe Stafe Confractors Law 78.27 RCW and <br />296.200 WAC. , � <br />Phone <br />�- yi6 ��zs � <br />Phone � <br />