Laserfiche WebLink
� <br /> ELECTRICAL PERIV��T APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> ,'(✓ OJ �J� <br /> � 411 `i �7� <br /> � / 2,S` l/l�e.-t�'►crn.f � <br /> PROJECT ADDRESS <br /> ���- �nfe-yt� <br /> OwnCr klailAtltlress Ciry Stale/Zip Phone <br /> Tenan( Mail Addiess C�ty StatelLp Z Phone <br /> n y s��� <br /> /J 1 4 kR�S �l eC1�'✓1 L (/(/li /`� r�l �'/-. J� cj 71 �-Z 3 3 3S� .� <br /> �i; SlatclZio Phone <br /> ElectricalCon�ractor MallAdtlress Y <br /> ['SI�� �-( �u�DR Q� � � �� <br /> Stale License Number(mquired) City of Everen Business License Number(required) <br /> � <br /> �F�c.� �tiGe- /�0O -' <br /> proposed Use of t3uildmg Contracl Price of Work <br /> �n �'/,� yz.�-�37-3�33 <br /> Square Footaae Qf residenlial new constiuclion,remodel or aAdition) Contact Person/Contact Num�er/Finail <br /> Number�s(If low voltage) <br /> j� ZOAt,,.,o G�kc�?f' �� �G-te _ <br /> Description of`Nork lo Oe Oona _ � <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � � � D <br /> 1 herehy cr.rtilylhat 1 have read and exammed Ihis applica6on and Wiow fhe same fo be frue and __... _ _ :-_—_- <br /> conecf. Illl provisions ollaws and ordinances�oveming this type ol�voda will he compfe(ed l <br /> whefhcrspr.cilied l�eroin or nof. Thc 9�anlmg o!a Pennd docs nof preswne fo givc aufhoiity ln PERMITR I <br /> violafc or cancc!thc provisions ol any ofher statc or local law�c�ulafing consfiucfion or Ihr, r ( I <br /> peifonnanr.e o/consfrur.fion. Thaf 1 am aulhorized by Ihc o�'.�ncr ol this piroperty lo pedorm Ihe C I � ' /� O y(n I <br /> �vork lor which applicalion is made and 1 cornpty wdh tf�e Stafe Coii�iar(ors l.a�v 1827 KCW aiirl ._ � Y'� � <br /> 29G.200 WAC. <br /> S� � '" <br /> / -� _l� -- <br /> Signature ����' <br /> PCV6�OOP'9:?Oia ___ __ _ ._- " ___ — <br />