Laserfiche WebLink
� <br />ELECTRICAL PERII�'i!T APP�ICA710l� <br />CITY OF EVERE"�T PERII�IT SERVICES �_6 _� <br />3200 CEDAR STREET, EVERETT, WA 962C1 <br />425-257-8810 - FHX425-257-8857-www.everetlwa.org L �D3—Da% <br />APPLICATIONS ARE ACCEPTED FROM 8.4M TO 4?M <br />yZz� I-�y�- A�� s��+e � <br />PROJECT ADDRESS <br />�{��j',� �!� Ncy.�- fJ12�. �� �Lc `IzL�S �/�;�vc `„�k f� Lur'✓c�, GL�.�1. ��Z�,j <br />Owne� M�ilAddress City StaleiZip Phone <br />,�, . <br />Tenant <br />Electncal <br />�;verc �!Z'l� E� <br />Mail Address City � <br />, <br />Inr,, 1nc � {��'� �C�r �il�o, {=f,��7tcie <br />ACaress <br />CFr�� �H � �,- rt �'�� 3 G� <br />State License Number <br />I/j` (-�C( 5 ij i 11(.'(?. <br />Proposed Use of Ouilding <br />Descnplion of Work to Be Done: _. 1�'� I i� C C � l <br />NOTE: WIRING IN NON-DWELL;NGS IS REQUIRED TO <br />BE IN RA�EWAYS, MC OR AC CABLE. <br />CITY OF EVEREiT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily fhaf I have read and eraminod this <br />correct All provisiens ollaws and ordinances gov <br />whether speci6ed herein or noL The granfinc� ol a <br />violafe or cancel fhe provisions o/ any ofher sfafe � <br />pedormance o/construction. That 1 am aufhorizec <br />work lor whrch appficafion is made and I comply w <br />296.200 WAC. <br />J �'1 ,✓ <br />/ �if/z Llc� <br />L ,l:�l.C'l.l:��� C f�� <br />�,1,r1 `IF%✓ <br />St2le2ip Phcne <br />, U,r�l. %bC1E; `11-5-�1f'il-3'{'Il <br />City State/Zip Phone <br />� � I L . c� _ <br />Contraci Price of Work <br />Contact Person (Plan Review) <br />and know fhe same to Ge frue and <br />ype o/ H•ork will be completed <br />v not presume to give aufhority fo <br />regulafing co.�isfrur,fion orlhe <br />ier o(Ihis properly fo peAorm the <br />� Contracfors Latv 18.27 RCW and <br />�3-o�-oy <br />FEE <br />ELiG3 CZ5 <br />