Laserfiche WebLink
ELECTFtICAL PERMIT APPL.ICATIOhI <br /> CITY OF EVERETT PERMIT SEP.':�lCES <br /> 3200 CEDAR STREET, tVEREI-f, VVA 98201 <br /> 425-257-8810 - FAX 425<57-8857 —www.everettwa.org j� /1�� l 3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C 1 �jQ(`- L� 5�" <br /> Ic�� �;I �-J ���+> ���1� �� `�ix ���J <br /> PROJECT ADDRESS <br /> �. ,, � I <br /> �; 1�; .5� .� �'�C '� <br /> Owner Mail Address Ciry State2ip Phone <br /> Tenan� <br /> Mail Address City StatelZip Phone <br /> n����o�}Ji�'1 I��&k�� L '�>>.i l.,l� ��1��'F � ��f�� LJ�' � ����<Jl� u�� �V-?� `� <br /> State%L Phone <br /> Eleclrical Coniraclor Mail Address �'b' P <br /> 1 <br /> .1 ,�` � � .` ;r�; — I <br /> � �\��� ��v\ 1 C I�� VJ � l� � CoNracl Price oi Work I <br /> Siate License Number <br /> �; ZC,t.�O �; <br /> Proposed Use of Buii ng Contacl Person (Plan Review) <br /> I <br /> Square Footage Qf residential new conslruclion, remodel or addition) <br /> Description af Work to Be Done: �/iV` �,` � �/��<�� Ca�C� �� C��'�(7 - r��OL � � �' <br /> ,. <br /> � �� IIL(.l�C '�) - <br /> ii <br /> I NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE �G� <br /> , BE IN RACEWAYS, MC OR AC CABLE . <br /> i <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceriily thaf 1 have read and examined this application and kno�v the sarne to be liue and �� �, C <br /> conecL All provisrons allaws and ordinances govenung fh�s type oln�ork�vill be wmplefed � — G /Z, <br /> �;�hefher specd�ed herein or noL The granting o/a pennd does not preswne to give authvnly lo �� :- � <br /> viclafe or cance.'(he provisions o/an}�other stafe orlocallaw regulating consWc(ion or lhe <br /> pe�formance af cunstn�c6on. That 1 am authonzecl by Ihe o��mer o(this piope�ty to perfo�m the <br /> �vorl<lor which application �s made and I comply�adh the Sfate Contrac(ors Law 18.27 RCW and <br /> 296.200 W/1C. <br /> �' � �� i ---- i -�'9 - l 3 . <br /> � <br /> �I i��� ignature Dale <br /> �i . . __.._._ . . . _ . <br /> �_.___--- � — - . . .__.._- ----..__ � <br />