Laserfiche WebLink
a�,� �3 2,��, p i9aN� <br />N�� 84i7 F ; <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREE7, EVERETI, W� 98201 <br />425-257-8d10 - FAX 495 757•8857 —www.everettwa.orp <br />I <br />--����1)� �n�'L-Y���.Q,�vr.� <br />PROJEC7 ADDRESS <br />�v D—��Z � �YU� �1 � 1 • l:'. ��.,a—! ��I�IL4.YPli.-�iA--��LZOIo— 41� 3°y" �l <br />owner rna i nearess Crt� siace2�o Fnc�e <br />�OD R�,.,� y_�no AIvr.A f�,r re�Qf��- �?4 � 421- 4 75 -�l(r`! <br />Tenart Nml Adarese f C4y Stalc/Zw ph.cne <br />��--- 34tY1 £�>vye� �ve, �.,�eare (�l�.V�- �j�! uti- z,-z-ti«c <br />F�ennca�Contracror MailAaa�ess Ciry stateZp P�o�e <br />��S H T6SN9�� <br />Stat¢ L�censa NumScr (requiryd) <br />Propc=ed Use o� Bw Cma <br />Square Foo;age (If �es�denbal new eons6u�,wn, rcmode�� or add�tion� <br />NumOu� ol aehcee (II iow voilapr.� <br />�.._���� <br />Crty ot Everetl Bucness f i�ensa Number (requaeu) <br />��.--. ... . <br />CoNrac! Vriec ol Work <br />Contact Person/Contnr.t Num6er/Emad <br />�escr�pt�on uf WorM to Be D�ne � 1� G. � liA�}'�U . Uk RT,,�, 1/�_� � <br />CITY OF EVERETT LpCAL SAL[5 TAX CODE IS 7105 <br />I hercby curhly f0a116ovc ryad and eAaminrJ fhis apphca6on and Mnox• Mo same fo De troe anA <br />conocf A!1 provisions ol la�tis end ord�nancns ,qovrming this type ol woik will be comploted <br />�rhof�er spec�ficd homm or not The grentmp ol a permR does no! O�sunre fo ylvu auf�onty lo <br />via/��p or cancel fhe prov�srons o! any nther sfafa ar Ixal lav� rcgulahng conshucfion or fhe <br />peAorm,n�e ul construeflon 17ra1 I am aufhonreJ by Mo owner o� th�s p�upurty fo pcAarm fhu <br />work lor whicb epUNca6on �s mndo anOl compty w�th ihe Stale Contredors law 18.27 NCl1� and <br />796 200 WA <br />-- - sl'pnalure -- ---- ..�_� � - <br />4tvrsm escs^ora <br />FEE � <br />��°� � <br />— - — —J <br />PLRMITp <br />E ��o�-a�► � <br />