Laserfiche WebLink
01/20/2010 14:32 FAX 4258357830 1'AHNIA.l. FLEC TRIC Idj00.' uo-, <br /> ELc,CTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, SNA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> Ja 2 z TH S T f E "A +(� <br /> PROJECT ADDRESS <br /> kLOFcf <br /> _� a6o us4 rle� <br /> � Ea.l k/kfLLA �1Db�_�_�tlU_ESF S.ic,ML..rril 1,1A_9Bzan <br /> Owner A1a11 Addiuss Elly State/Zip Phone <br /> Tenant Mail Address City StaleZp Phony <br /> V <br /> 4Ls ?St 7600 <br /> VA^ -'E"CiA�t2lLSp14 LAO' S- cQ 9L LArc6 ST�yc rs v,t� ti87.5V <br /> Electrical Contractor Mall Address City Stale2lp Phone <br /> Y�LLhi E&S �i 7 gM G a a C,-7 S- nr7 <br /> Stale License Number Contract Prl of Work <br /> n�Cros'_F_,c n..'sal- t�f (.) to ITS <br /> Proped Use of Building Contact Person (Plan Review) <br /> 1 1 <br /> Description of Work to Bo Done: 5; Zk� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE 19 3105 <br /> I hereby cerfily that I have road and examinod this application and know the some to be(rue and <br /> correct. All provisions of laws and ordinances govominp this type of work will be completed <br /> whether specified heroin or not. The granting of o permit dons notpprosume to give authodty to <br /> violate or cancel the provisions of any other state or local law rogulafing construction or the <br /> porfomlance of construction. That I am authorized by the owner of this pproperty fc perform the - <br /> work for which application Is made and/comply with the State Contractors Low 16 27 RCW and <br /> 21/966.200 WAC. <br /> ll/ SlOnelure patTh <br /> t_ <br />