Laserfiche WebLink
Feb 02 1501:29p Ferrin Electric Ir1q 4253377746 p.2 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> .3200 CEDAR STREET, EVERETT, WA 82 <br /> 4 425-257-881Q -- FAX 425-2s57-8857_ ey,eretfwa.o> <br /> , <br /> gu <br /> _ 7)507:3'.. , <br /> ._ _,-- -__ go ik 0,e,1,,i c___4?:, . <br /> _ ._ . I <br /> ir,....%Liont.--4,112...- r. G. A - . st )A i-r <br /> PROJECT ADDRESS <br /> oic <br /> L ktdi <br /> �r • 1 w #\ Nqo l l_ LV '1'1A <br /> Mail Address City <br /> Staterzo Phone <br /> Tenant Mail Address <br /> -i'\rii) Lk61%1, Mn�64, iU(b ,ContraetorMO Address <br /> City <br /> fAl ` StateIZip <br /> Phone <br /> Electrical <br /> City <br /> %0%). ItS 33--)53S <br /> SlaletZp Phone <br /> State License Number --- <br /> Cortract Price of Work <br /> 0 'w tic a s <br /> Propos=d Use of Building . <br /> Contact Person (Plan Review) <br /> 1 <br /> Square Footage(If -. _. :- newconstructiOn.mei or acid-don) <br /> Number of devices(lf low voltage) <br /> Description of Work to Be Done: .4. - r_��,, <br /> Ce f l;\ S Q-Ke tai c ! <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 FEE <br /> thereby cettttfr that I have rand and examined this i D� <br /> correct All provisions of Taws andorrtlrrarwes application this <br /> type know the same to be tete and <br /> svftethersAecFired herein orsot The �D1��his type of work will be completed <br /> violate or cancel the provisions of any��erstate or l n u same to give auf-theyio I'ERNIIT# <br /> performance of construction. That l am authorized by the own of thisp �to erf rm the <br /> E.„1... 1.6.---61+0=- <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> C . `�o�- <br /> ��� _ �s 10 <br /> Signature <br /> ■ate <br /> REVISED3020113 <br />