Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-881n - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />Cj57zGs1 <br />PROJECT ADDRESS <br />Alm- 4Zf — ifs- d �y <br />Owner r Mail Address City Slate/Zip IMY Phone <br />Tenant Mail Address City State/Zip Phone <br />PY1ZA-AAh6 c2EcRn«- P.v.agc 9(qf EhnLifvlvs CV - dW42o-0q6s' <br />Electrical Contractor Mail Address City Stale/Zip Phone <br />YAAME/v7-7 l<,\A/ <br />Slave Licen-e Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Dodcription of Work to Be Done: j6Zzq,"7y� t6M, p �. C�1 i1T/C^r0V� ZOOT �7 <br />/V2c'..) 20C)A— <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TJ FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know the some to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not resume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />4 Wt( (_� r'L_ 7- <br />S nature Date <br />