Laserfiche WebLink
07'14 2010 08:24 FAX 4253357830 VARNEI.l. L:LFCTRIC �002/004 <br /> , <br /> 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 /> 1 APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> (o l S 60-t* 6T- SE j <br /> PROJECT ADDRESS <br /> i <br /> n i <br /> �/e /'ev �� ll r'4w it P0&x /304 ,G> usv,Ile �/ <br /> r✓r�/�7o37 <br /> Ownor Mail Address Gy Stete/7Jp Phone <br /> it <br /> Tenant Mall Address Gy State23p Phone <br /> VA -YWil t`lezlr,4 Tr<c II-- s w4%, — b_�.j <br /> Electrical Contractor Mail Address <br /> city 6 te21p Phone <br /> 11�41tit/ 4 E-T- 9 79-/q <br /> Slate Lioenoe Number Contract Price of Work <br /> sr {ra'l /7�t/5r✓t9 <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: _ W r��— {JVp ll.X 7,91y/ ype) Sq Fr— <br /> NOTE: WRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE 18 3106 <br /> I heroh certlry that I have read end examined this eppllcaf/on and'now the sgma to be truo and <br /> conectY All provlypns of laws and ordinances govemin this typo of work Kill be completed <br /> whether speolf! hareln Or not. The gronGng of a permit does not presume to give authortfy to <br /> violate or cancel the pm,4slons of any other state or local law regulating construction or the <br /> perlonnance of construction. That I am a ho zed by the owner of this roperty to perforrm�the <br /> work for which application Is made end I comply with the State Contractors Laj 18.27R CW and <br /> '96.200 WAC. <br /> � Signature Date <br /> E( aO7 -vyf <br />