Laserfiche WebLink
ELECTRICAL pERMIT APPLICATfON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 g�� � <br /> 425-257-8810 - FAX 425-257-8857 –www.everettwa.org /�J—/ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C�Z�� �� 3� <br /> I � I � � I� JP�'-�;� PFr1 �'�-�^� SJ1 �� �-V?��I����/`��� <br /> PROJECTADDRESS� I <br /> Owner Mail Address City SlatelZip Phone <br /> �- i � <br /> Tenant Mail Address City State/Zip Phone <br /> � �i � �P�'F c� �,c �'20� �'i`'i �S! C+ � �'� - �.nrrl � �ff c1�3>�i iS3-5'(.•5'-3� %C+ <br /> ElectriCal Conlractor Mail Address Cdy State2ip Phone <br /> �� UUU. CC1 <br /> Si Ai�r+—`JS1C'f,� <br /> State License Number Contract Price of VVork <br /> �[/1 / � �P11C c' �-•rf;� �_ <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Square Footage(If residenlial new conslruction, remodel or addi�ion) <br /> Description of Work to Be Done: � L I� r' �- � � 2�'�' '�� �I�S a nv i �Cu f� ��% <br /> ��11 "i - �"� ' �r �i �� GIv�lJ �i'^V i° �11 �r��Cn <br /> i " � <br /> NOTE: WIRING IN �JON-DWELLINGS �S REQUIRED TO F�E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily(hat I have read and examined this applica(ion and know the same to be fnie and �' • r� r� <br /> conecf. AO provisions ollaws and ordinances govemmr�this type o(work�vill6e complete� � �a � v - � � ✓ <br /> whetherspeafied herein ornot The granting o(a pemut does notp iesume lo give aidhonty fo <br /> violate or cancel fhe provisions of any ofherstale orlacal law regulating const�uc6on or fhe <br /> pe�/omiance o/consWchon. Thaf I am authonzed by(he ownerollhisp roperty to perform the <br /> work(or which application is made and 1 comply wdh fhe State Conlrac(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> `� �/' <br /> : � �Y,��-- I 0 - I �1- ZC IZ_ - <br /> " Signature Dale <br />