Laserfiche WebLink
�LECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 (� --� � " �S <br /> 425-257-881D - FAX425-257-8857 —wvvw.everettwa.gov <br /> C �5b6--��i`� <br /> 2��� coi� , A�� <br /> PROJECT ADDRESS <br /> Owner Mail Address Gry Slale2ip Phone �I <br /> K�� A,� G��n:IZ zti3� colby �. E�„�l+ G.�. 19��� <br /> Tenanl MailAtldress Cdy State2ip �none <br /> C,�1 N¢c+��at� Caol•v�s �a� 3ao5 �;�r�G�rur� 4� l9dob3 _H25-62(-l�(3 <br /> Eledncal Con ac;or Mail Address Gly StalelZip Phone <br /> C��MI�FFM�53Q� _—�`,�5—�7 <br /> State License Number(reqwred) City ol EvereU t3usmess License Number(reQuired) <br /> Re�"cturan-�' Z� <br /> Proposed Usc of[3wld�ng Contred Pr�cc of Work <br /> �eremv Mo�lle� yZ5-f�zl-IZt3 <br /> Square Foolage(It residential new construction,remodel or addition) ContaG Pe soNContaa NumbedEmaJ <br /> � <br /> Numhcr of devices Qf low voltage) <br /> � I ✓1 (� <br /> Descnphon of Work lo Be Done: �(.1( I � � IPw �'ell'�'�DST� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � C�"�e OD <br /> "J <br /> 1 hereby cmLly Ihaf I have road and examinod Ihis apphcolron and know Ihe samv lo bo Vue and ____ <br /> conecl. �II pmv�sions o/Imvs and�rdmnnces govmning fhis fype ol work will be cornplefed <br /> whelher spr.nlied hemm or nof The granGng ol a permd dor.s nol pm.sumo to give aulhonty fo PERMITN <br /> violafe a canccl Ihe provisions ol any ofher sla(e or local law regula6ng construclron or Ihe ^ I��/ � „(� <br /> perlormance o/r,rnislrucfion Th,al I am aufhonred by Ihe owner o�Uiis properly lo perloim the t I.LD (�r � <br /> work lor�vhich opplica6on�s made.�nd 1 comply wifh Ihe Stale Confraclo�s Law 7B 27 RCW and _ <br /> 296.200 WAC <br /> � �l-l '� , r <br /> ignalv � Ualc <br /> i.�_���,incn"',:,�,� <br />