Laserfiche WebLink
ELECTRICAL PERMIT APPLICATIGN <br />CITY OF EVERETT PERMIT SERVICES <br />3200CEDAR STREET EVERETT <br />, WA 98�01 l � <br />4.5-257-8810 - FAX 425-257-8857 - v,vnv.everettwa.o�g -j —� l�� <br />APPLICATIONS ARE ACCENTEC FROM 8 AM TO 4 PM <br />/�/�) l �o? �`� i f . <br />PROJECT ADDRESS <br />� U'gU3-Of�o <br />OE81T 8 CREDIT GARDS ARE NOT ACCEPTED <br />�-/.) 3' <br />�^ l� �- ,� ,� �...,��s /r��rt <br />Owne�S ���;_�--f��- s iSFI /3� `�sr s� c�:�.�Yl 9=�h�� <br />h7ail Addmss �� <br />� City Slatc/Zip � t�yr• <br />IS-�c� ��w� Sr- l�s <br />>�ry �9�uuc �( tc�r�v 1� ��M 9;S:.�o> a��/,�'/�� <br />Ma�l Addmss <br />LICGIfiCill <br />A1ail <br />�`>KIcjF �-�- C�>t�/� Q <br />State icr.nso Number <br />I�t �f�� � C <br />Proposed Use of 6uilding <br />City <br />City <br />Stafe/Zip <br />5!alelZip <br />SD c> L, <br />Contract Pnca of Work <br />Phonc <br />-Ti � �� a�t � � � �2 — <br />C�ntacl Person (Plan Fevicw) <br />Dc,cripiion ol Work to Oa nono: 1/J �j%1 <' (� (/ J E x���•� 1�^ .�LLu �J <br />�-�.E� C C �� �n <br />NOTE: 'NIRING IN NON-DWELLINGS IS RE�UIRED TO <br />BE IN RACEWAYS. MC CR �C CA�LE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 5105 <br />I homLy r.rrtdy tl�at I have �oan and exammed this application and know the sarne to be We end <br />cnnerf. All provisions o/ la�.vs anAorAinances goveming this fype o/work will Ge eompleted <br />�vhefher speafied herein nr nat The �ranting o/ a permrt doos notp resumo fo giva authonty fo <br />nolate or cancel tho provisions o/ any other slafe or loca� law regulafing consfrucfion or tho <br />perinrtnance ot construchon. That I am aufhonzed by fhe owner ol fhis pmperty to pedorm Iha <br />v:ork Inr whir.h applicatinn is made ond I comply with fhe State Contractors La�v 18.27 RCW and <br />296. 200 IM1�AC. <br />i� <br />i �/J / <br />I /� L I'i /f li{,{, f �/ L C),_� <br />;�„��:,,. 7;�� <br />� <br />FEE <br />�� �� � �/ <br />� <br />