Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br /> � nG��� � 3r,f �I,ir w� � vv,,�'i <br /> PROJECT ADDRESS <br />� ���cd-� C�., .� ;��t�E �oN Sr� �,.1?/'fs�'vi/l� l,�/:. ��1�''�'za �3���1 �;s>- lA't'� <br />' Owner Mail Address Ci�y Stale/Zip Phone <br /> Tenant Mail Address City StatelZip Phone <br /> ��� ��f��2� ��ccia �� l�l� i�nf /P' Z �-�Oi7fspr/lr �(/Gr � �7�c� /�s�S�o-/3�0 <br /> EleClrical ConlraCtof A1ail Address City Slale/Zip Phone <br /> Ccti,r��� �/l�'�/3 <br /> Stale License Number Contract Price of Work <br /> � 1� l� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Descriptian of Nbrk lo Be Done: � �' �' �C' '� ' '� r � ���'`- >r ��'�i7�,�'C <br /> ��- r�`� l 1=c �i� � F' Si7E c 7-�vU <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RAC�WAYS, MC OR AC CABLE. <br /> CITY Of�EVERETT LOCAL SAI.ES TAX CODE IS 3105 <br /> 1 hereby certily that 1 have read and examined this applicah,n and know the same to be true and <br /> correcL All provisions o(/aws and ordinances govenunc�thi<:type o/work will be compleled <br /> whether::peaGed herein or not. The granfing o/a permd dces nof presume to give aufhority to <br /> violate or cancel the provisions olany otl�er stafe or local law regulating construc6on or the <br /> I pedormance o/consfruction. That I am authorized by the ewner o(th�s property to per�orm the <br /> work for which applicalion is made and 1 canply with fhe State Contractors Law 18.27 RCW and <br /> 296.200 Vl'AC. <br /> �_!\ <br /> ,.�.-=--�`�— ��- 2S- C'� <br /> - SlgnaWrc Date <br /> Cd�t(- �Z � <br />