Laserfiche WebLink
I -r-• __ TION i <br /> � EL�CTRICAL PERMIT APPLICA <br /> I CITY OF EVERETT PERMIT SERVICES <br /> j 3200 CEUAR STR�ET, LVI=RGTi, WA 98201 <br /> i 425-257-8310 - Fr\X 425-257-8857 –�•�tw� �. eretUva ory <br /> I <br /> � <br /> � �J , I <br /> ' ��� �/fj�,%�/uT .� <br /> -- -- ---- --- -- I <br /> I PROJECT ADDRESS � <br /> I <br /> i /291T ��z< - -- � <br /> -- --- - -- _ __ _ _ -- <br /> -- - - — - --- -- <br /> 0:�.�er A1adAddress Gty Slalc�Lp Plwne � <br /> � <br /> � <br /> � _ l I <br /> .-___ � � _ . __--__._ _-_ . -____'__-____-___� _-_"._ <br /> fr.nant- - � ta�i� c�rrss �r,y Stato�l� Phone � <br /> I <br /> r � nrrc�CC �l�' (%r'4'�1(!��' � v�c i,✓A-� T� h'7" 3/9 fc*rZ j <br /> ��s l� t� Z�, � -- F-.� 1-��r�;� 3 A � --?-- <br /> �� Hc.Ir.,,�ICcn9;lciur �dadP�;n,sq Cty S�aic�J�p Phonc <br /> , 1�'�6£c �JZ{�(� -- — -- --- I <br /> ;�,I,�le L itei�sr t��nnbei Ccn'ract Pnz:ol bVo�k I <br /> � <br /> �' ^mpesed Usn ol Auitdmg Centact Person II'lan Revicri) i <br /> I Sq�aie Footage pf residential nevi construction,iemodel a addaion) I <br /> I <br /> 1 <br /> � I <br /> '�. N�mbei ul Je�ices (II low veit:iye) ' <br /> I <br /> / - -- -- -- - �--. _ <br /> �i✓� ' v✓ � � <br /> I I7esr.npl�un ol I;Voik la E3e Uonc� -- . �— �G _ --� � � � <br /> � <br /> I --_ _._ <br /> - — -- � -- -- _ ._ - --- -�--- - -- -- . . '_ ----- — � <br /> ------ -- i � <br /> IFLL <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 7705 I ,(b .(� I <br /> L " <br /> I hciCby certdy flraf I have road nnJ r�id�n,m�d flus app�r:ahon nnd i�no�v tl�e tiornc fo bu Irue anJ ._ ___ _ _ _ ____ � <br /> correcL NI provevuns nl laitis arrd oNurances yoverninq pns(y pe nl u�u�h �tr!1 be compleled -- - - - ---�- �— � 1 I <br /> �.:hefhcr specfieJ hr,;um nr nof 1 he y�anhny o/a pemuf does nof presurne fo give aulhonty fo Nf f2(dl l�# <br /> violafeorcancelfhe��rurivinnsolanyulhercfaler,rlecalla�vmgulafin9consfrucfionoifhe � I �n�'_' � �. -. I <br /> prrfonnance olconsfmr6orr Ih�d I arn aulhorrrr.d by fhe o�.rnernl!lus propeRy fo pe�lormllr� � <br /> �vo�k lor whieh apphcohon is rndde an�i I r.nrnply ndh fhr. S�afe Conhaclois f a�v iB 2711C1N�inJ .-- _-- - <br /> 796 ZO AC <br /> ���, _ � � <br /> ���- - ��-�� - -- --- - <br /> Sign,dure '_—_... . _____ - ._ Date <br /> i <br /> � <br />