Laserfiche WebLink
- .� ' � r ; . -�► - 1 � �.► � � , <br />ClTY t`�� �0/E��TT PERiU�IT ���iVI�E� <br />3200 CEDAR STR�ET, EVE�ETT, WA �8201 <br />425-257-8810 - FAX 425-257-8857 — �,� �.�, ,.� _�' �� � P. �,.` :' :L�,�,� - �r,>� ;�` <br />t, :-v.�t � � '. � t�L� r GJ'-}-�.C? � �,j- � � i/U'�a'r:-1"�`�<: ,�a� ' � ,� I '--° <br />`� <br />�y <br />�r� • � �=��' ., <br />; r` xw.., �--y �,�.i �: <br />�'R�J�C7 l�DQR�SS �.�..��� <br />���� <br />Uwner �� <br />(rov; <br />l':i w1 r� �`��' u C"�U' <br />l�enarit <br />i' u% � j� l'1,• !..1 <br />PAail Address <br />� .��� _ <br />��°•I � , ; <br />Mall Address <br />� � i;1�;:`�r� � l. re �f �' �-�' ( <br />Ciry'�_ � �_ State/Lip <br />City <br />Staiei�ip <br />l�h�ne <br />Phone <br />�� �(li:•I�U l.��i'•- •�l,i: L-'71� I L� � G` r`� u � f-( 1>� ? � -, , <br />IY � t; ! �,+- t f �'l�- t,+✓�i� �> �n.J � , � � � ' �. <br />--- � :.%"I.�'�,� ��75��)Z-2G,IC,,, <br />E l e c t r i c a l C o n t r a c t c� r � Mai i Address City State/Zip Phone <br />il �`A��..'= L�'� l- C.I- �� ��L 1,��'� ( Jh1� i: I"� <br />State License Number (required) City of Everett Business License Number (rec�uired) <br /># l � o `v � �`: i•Yt'� l�a ^� %7� � �, �}�� <br />Proposed Use of Buildirig Contract Price of Work <br />5quare Footage (!f residentiai new construction, remodel or addition) <br />� <br />Number of devices (if low voltaye) <br />� J l.,''-�1+1�,. i�-'� � TS' C• ' T'YtA l��l (�r5,^, �� N v.l i-I NV i 4. <br />Confact Person/Contact Number/Email <br />Description of work to Be Done: C� S��L� 1-1 /(��i:��,�,'�' 5-`1'v' i N � �l �'�'�'�.:��-�YtiE7v; �s� �:iG;-i7 S <br />� <br />`�l n�'-(l-L 9-,'''� r__ � a 7, f i%Z v �, � j-lc>L i� � ...-�) 4 f f7 i. c,E /�l... � <br />C►TY OF EV�RETT LOGAL SALES TAX CODE IS 3105 <br />I hereby cer�ify that l have read and examined this application and know fhe same to be true and <br />cor�ect. AI! provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permrt does not presume to give ac�thority fo <br />violate or cance! the provisions of any other sfate or /ocal law regulating constructivn or the <br />performance of construcfion. That ! am authonzed by the o�vner of thrs property to perform the <br />work for which application is made and I comply with the State Contractors Law 98.27 RCW and <br />296.200 WAC. <br />r,t v�sev oaio�izo ia — � � ' L � -�} �J �� <br />FEE <br />� ��;�� <br />PERMTT# <br />E l � (�� --- � � <br />