Laserfiche WebLink
--�---- -� <br /> FLECTRICAL PERMlT APPLICA�'ION <br /> CITY OF EVERETT PERMIT SERVICES j <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � <br /> i, <br /> 425-257-881U - FAX 425-257-8857 —www.averettwa.org <br /> ' I <br /> I � ��� E\1P.I�J'�e (� (nJGt/ I <br /> I PROJECT ADDRESS I <br /> � <br /> i <br /> Owner Mail Address City SIa�e2ip Phonr. <br /> �FICC pEPo i �1zsSl3aSI5 <br /> ITenant Mail Atldress Ciry Stale2ip Ph„ne I <br /> I �or � ilo���G� Sr«it7ef 7/Sot' /�G�� S�� C�fE .4n��Ey ��C C.�/A `�Y35/ Zs'3s'IS/y�`I <br /> Eler.triCal Coniractor Mail Atldress Ciry State2lp Phone <br /> /_OWVoV5�554Z �5���� <br /> State License Number(required) City ef Everetl Business License Number(required) � <br /> ( e Mi M 4�G l q, � � ��� i <br /> Proposed Use o1 Building CoNracl Pnce of Work i <br /> /ti'I�RI� SI�W 2s3 3rsiy3y � <br /> Square Foolage(If residential new com��truction, remodel or addition) Contact Person/Contacl NumbedEmail <br /> iv1 q,2/LC vS � Y/'rNoo.co tit <br /> /D ck.Mr;.f <br /> Number o(devices(If low vcllage) <br /> Description of Work lo Be Done: �� C5H C�= /N f�H��7�-/o i] , <°u��S rGc. 'ri7 �u„� 0 1T/C(� <br /> I <br /> FEE <br /> CITY OF EVERETT LOCAI SALES TAX CODE IS 3105 ��D UJ <br /> I hereby cerfity f��at I have read and exanrined Ihis application and know the same to be frue and <br /> corrocL All pmvisions o(/aws and ordinances goveming fhis type of work will 6e completed --� <br /> whMher specrfied hornin or noL The granfiny ol a perrnit does not presu.:�e(o give aufhonty fu PERMIT# � <br /> violafe or cancel Ihe provisions oI any other sfate or local law iegula(ing conswc�ion or the j��j C� <br /> peAormance of consfrucfion Tha(I am authonzed by the owner ol fhis pr�periy to perfonr,Ihe E I �� Z -V ` <br /> work lor which applicalion is made and f comply wi(h fhe State Contracto�s Law 16.27 RCW and � <br /> 296.200 WAC. <br /> � �/li'r�/��-�� /z � r� _ <br /> Signalure Dat - <br /> a[ms�o os�zo+a <br /> --- - — -- -. � <br />