Laserfiche WebLink
Apr 28 17 10:36a Bob Jack 0 496746777 p.1 <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 /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br /> PROJECT ADDRESS <br /> Owner Mail Ad Ass City Staterzip Phone <br /> r <br /> /r/t�/ ` c <br /> Tenant Mail Address City Staterzip Phone <br /> !f <br /> —._�.. <br /> Electrical Contractor Mail Address City State2i Phone <br /> �'L S LID 4- <br /> State License Number Contract Priof Work <br /> :7 e <br /> Proposed Use of Building Contact Pers. Plan iew) <br /> Description of Work to Be Done: /! <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 IS 3105 <br /> !hereby certify that I h ad and examined this application and know the same to be true and <br /> correct. All provioflaw and ordinances governing this type of work wit]be completed <br /> whether specifierwn or n . The granting of a permit does not resume to give authority to LL <br /> violate or cance�Rs <br /> provision of any of er state or local law regulating construction or the <br /> pertor mance ofructron. hat I a uthorized by the owner of this property to perform the <br /> work for which alication is adean I comply with the State Contractors Law 18.27 RC W and <br /> 296.200 WA <br /> - l <br /> S ignatur Date <br />