Laserfiche WebLink
p <br />ELECTRICAL PERMIT APPLIGAT�ON <br />CITY OF EVERETT PEryMIT SEF�VICES <br />3200 CEDAR STREET, EVERETT, WA 98201 6�-// �-D� <br />425-257-8810 - FAX425-257-8857—NnNw•everettwa.org ���,�_D�j� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��D S �JP��SC'P� 'Wa� G � o� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />, ���5 r�e{ rc�e�WA � <br />Mail Address <br />Mall Address <br />Ciry <br />w�y �������- <br />Cily <br />��- <br />State/Zip <br />,A- �/ �o�� <br />SlalelZip <br />y,z ��. 3 s3- � <br />i$��.� <br />Phone <br />4,�5�3n-�s�� <br />Phone <br />f i I � 1-CI'� �C ��- � Q,C�'{" <br />Electrical Contrador Mail Address <br />Ciry Siale2ip Phone <br />�lI,L1E5���513(3 �(��C�p O <br />Stata License Number Contract Price of Work <br />�,�cp �>�1���.n� <br />Propased Use oi Building <br />� <br />UescripGon of Work to Be Done: � I^5"�� � �' <br />NOTE: gERN �CEWAYS MC OR AC CAB EUIRED TO <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerfi(y that 1 have read and examined (his application and <br />r.onecf. AI! provisions of laws and ordinances goveming this fypo <br />or <br />_ I�' <br />Contacl Person (Plan Review) <br />1 rv, 5 <br />e to be truo and <br />completed <br />ve aufhonly fo <br />lion or fhe <br />to peAorm the <br />I8.27 RCW and <br />C �j�f <br />�EE <br />�U� _ U(.�� <br />