Laserfiche WebLink
ELE(:TRICAL PERMIT APPLICATION <br />CiTY OF E�'�RETT PERMIT SERVICES <br />3700 CEDA!i STREET, EVERETT, WA 98201 %' <br />425-257-8810 - 1=AX 425-257-8857 — www.evereriwa.org '� <br />APPLICATIOMS ARE ACCEPTED FROM 8 AM TO 4 PM <br />3/2iu �L�1�u�vuc,c�l� �I� <br />PROJECTADDRESS <br />Un�+�.> �Jc...i nF <br />s„`�,�.:,�56� c:��„i,,� �,z�� n,��������.I� sr E�.� �"rT� c,�f� �9�ao� ,�i�, <br />� <br />Owner MailAddress City Stalc2ip Phone <br />un�-1�c,e� i�.%�,,.� o ( <br />:->��o�\or��CL� Ccv.n..�- ti �12J M�nou�,�,1�1� Ev.�.rt+-j �)/\ `I�i�O/ N//� <br />Tenant Mail Address � City SIatMZip Phone <br />C a��� <br />N�••c�o���l� V�,\\er 7�11 �c�"�,,I �,.�-a Sw �St�.�i�.r L.�/a 9$IU(, ���i-v��� <br />EIeCIriCaICoNractor tdailAddress City Slate/Zip Phone <br />n�� ��.c>�^, r��F �� a(�F ��.��,`? <br />State License Number <br />� o n�� v� —c . � ; c: � <br />Proposed Use ol8uilding <br />Description of Work to Be Done: ���� �;;( C'�' � J <br />�� - �'�/-"� � . <br />NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J705 <br />I he�eby certi/y fhat 1 havo read and ozamined fhi; applic�fior <br />correcL All provisions o/Inws and ordinances �ovemmg fhis <br />�vhefhe� speci7ied Irerein or noL The granfing ol a penmf doe <br />violafe or cancel fhe provisions o/ any other stafo or local law <br />perfomiance o/ consfniction. rhat I am aulhonzed by tho owi <br />work /or which applicafion is mado and I comp/y wifh fhe Slah <br />296100 WAC. <br />_ � <br />i � � � r\ )t�''l.", <br />_ . . � -Signature <br />►� 5 q�l - <br />Contracl Price of Work <br />Dar�� f1.-�d�r��n <br />Contas� Person (Plan Review) <br />(a�6)7�-�i- `�a/(. <br />' know the same to be true and <br />ol work will be comploted <br />' presumo fo give authonty fo <br />�lafing consfn�cfron or the <br />�( thig p�operty to podomr the <br />nfractors Law 78.2,' RCW and <br />FEE <br />�Gl��'C�,3 <br />