Laserfiche WebLink
• <br /> ELECTRICAL PERMIT 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 /> .. . /127 AIR.PDe_T QoAtt . <br /> PROJECT ADDRESS 2®6- c"'P7/9 <br /> g 4 I o2T SAD 1-1-C-- 0.2V3r S£ 42.03 fAca to 15.1410 PA- 1 �`1° <br /> Owner • Mall Address City StatelZip Phone <br /> ttaLT.9oe-b gt?SSkWf55 Pfg/C 1427 MQ Qf_Qaao �l/lefT.wA (1s-;20y <br /> Tenant Mail Address City State/Zip Phone <br /> whit Sfc.uetr 5s rf _ Be. 192t PAU,MENO.OgIvt ' $l L t446r geoa 10.3'1/O.?-b 3>; <br /> Electrical Contractbr Mall Address City StateRip Phone <br /> • State License NumberContract Price of Work <br /> Proposed Use of BuildingContact Parson (Plan Review) <br /> Square Footage.(If residential new construction,remodel or addition) <br /> • <br /> Number of devices(If low voltage) . <br /> Description of Work to Be Done: I aSTPXLL ?-T . D iii c7 o e--s hm t) fin( /s' of s. ' <br /> FEE <br /> CITY OF EVEFRETT LOCAL SALES TAX CODE IS 3105 9 2-( • <br /> I hereby certify that i have read and examined this application and know the same to be true and <br /> correct, All provisions of laws and ordinances governing this type of work will be completed <br /> • whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or cancer the provisions of any other state or local law regulating construction or the 03 <br /> -0 <br /> performance of construction. That lam authorized by the owner of this property to perform the E /1/ - • <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> • '298.200 WAC. <br /> 4 1 I ,ILLtjai <br /> 3 —)z_ <br /> Signature Data <br /> REVISED 320"3. 'vlw 6 4/"r/v-(e - r , . co-v=1 <br />