Laserfiche WebLink
ELECTRI�AL PERI1lIIT APPLIC�►TIO�i <br /> CITY OF EV�RETT P�RMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> h �07 f e11�•� ddP 5�.���-e 1�-101— <br /> PROJECT ADDRESS <br /> ;\��� <br /> C� <br /> p COIb `''" C . 'I� W �J C' <br /> Y Slate/Zip Phone <br /> Owne� Mail Address City <br /> /�lerrill l.Yr1�l� c�.1o7 (ol� /��e� 5�;1-e 1y01 C�etiel�i� wk �18�to� <br /> Tenanl Mail Address <br /> C��, SlatelZip Phone <br /> �3�ot s� ac��ti 5 8e11r�ue wA 98W5 �Id 1N7.5act� <br /> � 11 �� �i�y StaleRip Phone <br /> Eleclric2l ContraClo� Mail Addtese <br /> �j^� �e [;i \�y bt �� ���� �`"� <br /> State Licenso Number Contrect Price o(Work <br /> D 1 � ` �� — Contad Pereon (Plan Review) <br /> Proposed Use of Building <br /> Descriptian of Work to Be Done: <br /> Sc�F A � _ L _ .� <br /> NOTE: BERN�CEWAYS MCLOR AC CAB EUIRED TO <br /> FEE <br /> i, ! <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 {- �,� �� �-�� <br /> I here6y certify that i have read and examined this application and kno�v fh�same fo be true and 1� <br /> r.orrect. All provisions ol laws and ordrnancr.s govermng fhis type ol work wdl be completed <br /> �vhefher specilied herein or not Tho granting ol a permd does not presumo:o give aufhonty to <br /> violafe or cancel fho provisions of any other state or locsl law regulaling constn�c6on or the <br /> performanco o/consfruchon. That 1 am aufhonzed by the owner of fhis property fo perform the <br /> �vork for which application is made and I compty with tho S(afe Contraclors Law 1827 RCW and <br /> 29&200 WAC. <br /> �f/,.�,����1�� /'� ��islo� <br /> S 1 Dale <br />