Laserfiche WebLink
10/27/2015 16:17 4254597996 HOME RUN ELECTRIC PAGE 03103 <br />. • <br />ELECTR,ICAL P�RIVIIT APPLICATI�N <br />C1TY OF EVER�TT PERMIT SERVICES <br />3200 CEDAR SiREET, E:VERETT, WA 98209 <br />425-257-8810 - FqX 425-257-8857 — www.everettwa.org <br />��0�- L����?��d � <br />PROJECT ADDRESS <br />��c�rc� 1�►�soa.1 I�I ��" �m�.►� �1r� E U��1T', (�l��i `�� ZC� I- l(0�7 <br />OWne� Mail Address City SRAte/Z!p Phone <br />�I � <br />Tenaclf Mail Address City <br />State/ZiD <br />Phone <br />{-� �n � ,�,`�- i�,� �. �• ��X ar7, l���ell r,�����vy � ��5��-a��i <br />�IeCtfic0l Contractor Mail Address CiEy Stete/Zip Phone <br />�4r�� ��a��.�z <br />State License t�lumber (required) <br />����,.�,�..I <br />Proposed Use af guilding <br />�� �� , <br />square Footage (If residential new canstructlon, remodel or addltlon) <br />� <br />Number of devices ({f low voltage) <br />City af Everett Business License Number (required) <br />� `��0�° <br />Contract Prica af Work <br />��ia�°,� ��� �� �D�-�-6�-��Di <br />ontact Person/Contact NumberlEmail <br />Description of Work to Be Done: ��Y1�V1 ��t`�-1[�� I�UL` t���C�I.LI`�' <br />CITY OF EVER�TT LOCAL SALES TqX CODE {5 3105 <br />! Ner�by cert;fy thaf ! have read and examined this applic$tion snd knc w the same fo be true and <br />correcf. All provisfons of /aws and ordinsnces governing thls type of �t ork will be complet�d <br />wfleih6/' SpeClfled hereln or not. Ths grantiny of a permi! does nof presum9 to glve authorlpy to <br />vrolafe or cancel the provlsions of any other state or loca! law regulafh g constructlon or !he <br />perfo�manca of construction. That ! am authorized by the owner of fhi > proparty to perform the <br />work for whlch application is mad and ! comply wr the Stafe Contrs�:fors Lew 18.27 RCW and <br />296.200 WAC. <br />!` <br />�p�cA7��S <br />Signakure DBke <br />RE v1S�D 0&'G6/20 �a <br />FEE <br />�� 0 <br />Z� - <br />P�RM�T# <br />E c�ll�~?1C� <br />