Laserfiche WebLink
�LEC�f�ICAL PERMIT APPLIC�OTION <br />CITY OF EVEREl"T PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />II-17-1y <br />� �-203 �,� � ��►� � <br />� d � �'��` � u� . l.� . <br />PROJECT ADDRESS <br />10� <br />Owner <br />Tenan� <br />Mail �ddress <br />Mail �tldress <br />Cily <br />City <br />Sfate2ip <br />SlatclZip <br />Phone <br />Phone <br />��uUlC�p � �--� ��f�L �zs f-��.�v-�.`f( �izw�ewte LS�. i.,;�. �z9Z �6� 7a2 6i10 <br />ElectricalCoNraclor MailAddmss Ciry Stale2ip Phone <br />6�vi�i��'�' ��� SWf� — <br />Slate License Number (required) <br />�...c_5 � i��J✓tT I �o- � <br />Proposed Use of 6uilding <br />Squarc Poolage (If residential new construdion, remodel or addition) <br />oS3 3 ;� <br />Cily oi Everetl Business License Number (requi�ed) <br />��5� o � — <br />CoMracl Arice of Work <br />Contact Person/Contacl fJumbedEmail <br />� <br />Number of devices (I( low voltage) <br />� � � <br />Descriplion o( Work to �e Done�. i� I r-< «' " �X �"� ��`' S S _ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS �105 <br />1 he�eby ceriily (hal 1 havc �e�id and examined fliis applicaflon and kito�� fhc same fo bc true tmd <br />correcf. All provisions ollnvs and oi�linances �overniny fhis type ol work will be completr,d <br />whethcrspecilied hercin o�noL The q��ntin� ol a permit does nnf presume to groe au(honly fo <br />violafe or cance/ Uie pio�isions ol any oll!er s(afe or IocaUaw �egulatiny r,onsfrur.fion o� (he <br />perfomiance ol Go �s(�ucfion. That I am authonzed by fhe owner o/ fhis prope�ty (o pedonn fhe <br />work lor ydriEli applidaGon is madc and I r.omply wifli)1lie Sfafr, Conlracfors Law 78.27 RGW and <br />296 200 W�l� � � <br />� � / <br />✓ _ �_ —i— ���/� / <br />_._ `-- __ --_��--- � Dae <br />Siynalwc <br />Ft :,.,�. n or;r,z�oi�i <br />FEE <br />�b`� <br />PERMIT/t <br />E��III-���. <br />