Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �o —�.�g <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> E05�'l�/D� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 281 $ HEW ��T AV� <br /> PROJECT ADDRESS <br /> j�ji GLv� D i-�-C 2g2o N�wri AuF Evcn�� l�M 98201 �- �tq-455' <br /> Owner Mail Address City State/Zip Phone <br /> Grt.iFF'���sc�oss�,�c.W �,:�ew4 L�-C�18aZi3iS7AVE ���tlAiCc57Eur�S�lrAw�25$ ��gcp <br /> Tenanl Mail Adtlress City StatelZip Phone <br /> I��R.vT � Ce�-�cT�LsKZ�n'L — SFFY4 �.t S t!�✓E � <br /> Eleclrical Conlractor Mail Address City State.2ip Phone <br /> / �� �ZOC� <br /> N �,Q- <br /> Stale License Number Conlract Price of Work <br /> 1,J ►KEvt�l �in5��,�.6` 2�v►� Y►��4-K .�rISE� <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descripiion ol Work to Be Done: W ���K� F'�Z- �%4�1K75 I F�r� 5 ��l(L l..r�V tk�S _ <br /> /}��0 GPS- ��cC.-s2ic,�YL ca�: �E.T i�1 3ATN2�ovt.� _ <br /> NOTE: WIRING IiJ 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 /> I hereby ceriily Ihaf I have read and examined fhis application and know fhe same ro be Vue and <br /> L��L�- � c,'a <br /> conect. All provisions o/laws and ordinances governmg tl�is type o/�vork will be cornplefed <br /> whefher spea(ied harein or noL The granfing o/a pernut does nof resume fo c�ive aulhonty fo <br /> violate or cancel fhe provisions o!any ofher stafe or local la�v reguPfuig construc6on or O�e � <br /> I <br /> pe�fomia�ce ol construc6on. That 1 am aufhonzed 6y!he o�vner ol ihis property fo perfomi fhe , / \ / <br /> work Ior��hich applicalion is made and I comply�vifh Ihe Stafe ConVactors Law 18.27 RCW and , � �� Y <br /> 296.200 N'AC. T�'� <br /> / <br /> �- <br /> ;� <br /> ��"i• .� �< �'_.' � � `� � � <br /> Signature Dale <br />