Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � �a 3_o�� <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org C�g� `�.�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 3003 W C0.5ino (�\ ��IS -� 3� Z C�r,.e-F�-, w�1 �1� �-�3 <br /> PROJECT ADDRESS <br /> (I+�SH.c.r ��S"iiuCk�on� ��S-3 � <br /> �e� n� �o. `P� 13oy. Zfio Q�tiyc.�u:p wa `183 �� �-lyb� 346� <br /> Ownef MailAddiess City Slote/Zip Phone <br /> 3ou3 W Casic�� 2c1 <br /> Q>oe�hG — SU�g L•sw F�ere-H- i.�✓a q� �13 N/A <br /> Tonen! MailAddmss Cily SIa1NZip Phone <br /> Cao�) <br /> Y�o,cl�onA1�, yv�,\11�,i ��i-1 Oc+-. orl- /� Sw SrA'itt� wh qR�ul� �eg.�1�79 <br /> Elocidcal ContrActor Mall Addmss City Slalo2ip Phone <br /> � l i - <br /> ✓�t4C� on�r- 9�a f�F �/�'v9 rC Y� <br /> Stotv Licenso Number Coniract Prico ol Work ��Z S� <br /> \' <br /> 11/lo..,rk kl � A ��eb-57o � <br /> r u v�n+�-vr�c a� <br /> Proposed Use ol Building Contact Person (Plan eviewj <br /> Description of Work to Oe Dona Qp [T ' �V W ✓ U ��A�tp � `S'rF-1r G^/�O� 0��� <br /> ✓�'�IGC � uW VJ���•tnR CO�i'o�f• <br /> NOT[: WIRING IN NON-DWELLINGS IS REOUIRED TO FEE <br /> BE IN RAC[WAYS, MC OR F�C CADLE. <br /> CITY OF EVERETT LOCAI SALES TAX CODE IS 3105 <br /> I h.areby cortily thaf 1 have read nnA exnmined Ihis applicnfion nnd Fnow fho sarne fo be frue�nd <br /> correcf. All provisions o/laws nnd oidmnncos�ovorrring Ihis type ol work will be complefed <br /> whntlior spor.ilied hercin nr noL The granting ol n pamuf Aoes nof p�esu.mo fo c�ivo aufhority fo <br /> violalo or cancel fhe`vovisians o!eny ofher sfafo or local lnw regulafing constnicfion or fho <br /> performanca ol construction. That I nrn nuthorizod by fhe owner o!tlris propa}y lo perlorm fhe <br /> wnrk!or whir.h applic�fion is madc nnAl complY wifh Iho State Confracfors Lnw 18.27 RCW nnA <br /> 79f>.200 WAC. <br /> ��� a�,_�-��lY.� 9 - z 3 - o� � <br /> , iyna ure �/�(Ll.n '70 LL Date � <br /> t: 08i17- � �' <br />