Laserfiche WebLink
03/it/2015 03- 13 :7?�8 P 001lU01 <br /> ELECTRICAL PERMIT APPLICATIQ�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> j 425-257-8810 - FAX 425-257-Bg57—wv,ny.everettwa.org <br /> I <br /> � � ��Z� � n��-� �4 L��S <br /> � PROJECT ADpR�SS � � � <br /> �k.b(�'_`�Ui� � /C��'d.L�w S��l� S/��('z � <br /> Ownet Mail AdCross I <br /> C'y ;��2iP Phorc <br /> I <br /> Tenant MailAetlress C�ry StaM2ip //� Phonc � <br /> �'��nll� S'x.P l�d �D�^ �� 9�',ta� y��/�/ <br /> I Electrical Contraetor ModAdd;ess City Slata/ZiD P�one <br /> ��1�����-L� O / , 3 ��� <br /> Slaln Lic;enso Number(rayuired) Ci;y of Evorett Bu;iress Llcenso Number(reGuiretl) <br /> GU�/I.(� ,I+�!'�¢(Jlf/�t/ _ �OG� oi <br /> Proposed Use of 6w'd�n9 Contract Pr'ce o(1Voik I <br /> �i�l yZ..l� �3/ �� ,�I <br /> Squaro Footaga Qf residen;ial new construCtion, rcmodel or adddior�) Contnct PersonlConlacl NumbedEmail <br /> Number ot devices(Il low voltage) <br /> DescnpUon of Work to Bc Donc: <br /> _�__-��.c:��������.�-� <br /> / /��h a��� � /_�,���1Sr___1�-�=�/1�-�����-- <br /> , -- ----� � � <br /> FFE e-� �G -- � <br /> CITY Of[VERGIT LOCAL SALCS TAX CODE IS 3105 �� �_ <br /> I heroAy r.Artr/y lhal I havo road and oxamined fhis apphcahon and know tho samu to Do!/uo and <br /> ccrr�ct. All pro�/sions o/la�vs and ordinnnces govarniny this typa ol K•ak�vdl be complefad --_ � <br /> whelher specified hcrein ornuf. The grnnting of a permif does not prosumo to give authontylo peRMIT?I I <br /> vro/afe or cancel th e provis;ons ol any olher slafe oNocol la�r mgu/af�ng construcrion or Iho <br /> pe�formancc of conaM�ction 7hat 1 am nuthonzotl oy Mo o�mcrof th�s proporty to pedoitn the E lr-� � <br /> work{or tvhieh a plic ion is made und I compty wifh thc S�ato Contraetors Lnw fA.27 RCV✓and I " O � D�� <br /> ?.9Q.200 WAC. <br /> _ ,.,_,:G��� /� <br /> ature / pa� <br /> : ,srnc.ios-:m� � <br />