Laserfiche WebLink
_ _ <br /> - - <br /> ELECTRICAL PERMIT APPLICATION <br /> I' I CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 --www everettwa.org JG � '3 _ � '3 <br /> �� 3ns .-oa5 <br /> rl � y GL,^, ; o„/ P� �vtL I <br /> ,y <br /> PROJECT ADDRESS 4?5 -� �! � <br /> � n �'9� J F ��, y G �,vii - Pce �� (:�l/cn�/T (Nq y�1�/ ,'_% i��l; ' <br /> .s N n y F; <br /> Owner Mail Addrese City Slate2�p Phone <br /> i <br /> Tenant MailAddress City SleterZip phone I� <br /> NAN1�r' tLCGT�c rr'� ��//� � 1HD 1TJC L�J/1CSTc✓c�'1 L�N 9�tfd' `�25 .33;�_�/ I <br /> _ �y,�. <br /> Elec�rical Contractor Mail Adtlress City SlatelZip Phone <br /> //� /J1t �� v' l �' ✓/J � / > o - .� o _ �� <br /> State License Number Contract Price of Work <br /> Proposed Use of E3uilding Contact Person (Plan Review) �i <br /> I <br /> Square Foo�age(If residen�ial new construclion,remodel or addition) I <br /> � <br /> Nurnber ol devices (II low vol�age) I <br /> DescriptionolWorkloBellone�. _ ��P�9 � �� �=X�J �� ' " f �� �� �f W��f� � Fw I' <br /> 7 0 0 �l.J <br /> - __ ______ _.'__'__—_ <br /> .. .. _ .. . . '—. _ ___'_ I <br /> FEE <br /> CIiY OP F.VfRETT LOCAL SAL[S TAX CODE IS 3105 � <br /> � � <br /> I herqby certrly fhat I have rend�ind exunrined fliis applica6orr and kno�v the snme ta be 6ue nnd _ <br /> cormcL AI'^rvvisions ol laws nnd ordinnnces gaveming(his type ol wo�k will bo completed � <br /> WIIC(IIPI ;{..,r,rGnd herein ornof. The yrnnfing ol a penni(noes nof presume fo pive nuthority lo PERMIT# <br /> Iviolnfe or cnncel iho p�ovisions o/any other sfa(e orlocnl Inw regulnfing constnicfion or Uie �-- - <br /> perinmrnnco o/corsfn�ction. Thnf I nrn oufhonzed by fl�o owner al this propeity lo pedonn Ihe E ` j J `J- ('�� <br /> I �vork/or wnich npp6.�fion is nmdo nnJ I comply wilh fhe Sfafe Conhactors Lnv.� 18.27 RCW and <br /> I 296 200�C. <br /> �'�� �(�i- /Lf ry�j' � ,7 0 / L _ <br /> �- -�` Signature Dato <br /> I ,.: . .. .. �� -----._--____ .._-�-- --_J <br />