Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ' Z ��(_d (p <br /> 425-257-8810 - FAX 425-257-8857—www.everetiwa.org <br /> C-ob I ?-o5 <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> ��v C'��'a� �t� <br /> PROJECIADDRESS <br /> 011i I f Sc�rFH�e B�.nnen �JI�/ (ana�d T eff, ulA. qBZo/ <br /> e� r Maii naaress aty steterziP Pnone <br /> ��rl�`�lP_�" �ia��'�I — <br /> Tenant i ndd�ess cny Slele/Zip vhone <br /> �� /n � � 425 742-06�aZ <br /> R. f /���. .��s �.3��'ST:S.�(�`A �Nn��xd, w� as�� <br /> ElBtlriCelCan�reClor MeilAddress Ciry Stale/Zip Phone <br /> �rn�kr��t.�s 20. Cx.�.00 <br /> Slale Llcense Number Contracl nce o1 Work <br /> r����� <br /> Proposed Use of ilding Contact Person (Plan Review) <br /> Descnp6on af Work to Be Done ,cJ o2Gba�na /208 doff Oai1,e l f�rans�r�. <br /> � 1�C �1(d�1p,�.t �AUiDm�itf _ <br /> NOTE WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS. MC OR AC CABLE -- �- <br /> ��r�� <br /> CITY OF EVERETT LOCAL SAIES TAX CODE IS J705 <br /> I homby cortily fhaf 1 have read ond exarrunod Ihis applical�on nnd kn^�v fhe samo(o be fn�e and <br /> correr.f All proms�ons ellaws nnd ordinances govemin�fhis type r,'❑ ��F«vll be completed <br /> whefher specdiod Itore�n or nol The gran6ng ol n pernuf Aoes nof rt•-:� me fo arve aufhonty fo <br /> v�nlafe nr r,ancel Ihe prowsions o!nny ofhor slafr or local law regu�fc�r. constn`�chon or fhe <br />� per(orrnanco ol consliuchon The1 I mn�uthonzcd by Ilre owno�ol flus P�oparry fo peAorm the <br /> work lor which epphca6on is matl�i anA I comply�rdh Uiq Stalo Confracfo�s LAw 18 27 RCW and <br /> 296 200�l'AC <br /> �_� ����� <br /> 'ignature � Date <br /> � � <br /> /-,/L ��� <br /> L- �!� <br />