Laserfiche WebLink
07/08/201d 13:59 4252227949 ALL STAR PAGE �2/02 <br /> ELECTRICAL PERMIT APPLICATI��I <br /> I CITY OF EVERETT PERMIT SERVICES <br /> 32W CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAiC 425-257-0857 —www.everettwa.org <br /> � <br /> � O�. Ev�2fc^�'@�Q���5��.� 1,� y <br /> PRWEC7 ADDRESS <br /> ����2 �Q �e sta,e�L'a ancne <br /> ��r Ma�l Mdress �'�Y <br /> • \• W�. 1. l 1 '�U�. ��r ' t _ J k� <br /> Tenant , Address Gity Sfete?p P�O� <br /> 4as-aaa��s <br /> A-1\ S��r 4� e�,,�., �t � � 15� �-a �C,.l.l C ��. ui Q u <br /> ElecinCalCOnt2dof BilAddress Ciry StatelZip Phone <br /> �� i S� 1�1�-U 4 v4s �< �l 60 �o a <br /> State Lioense Numhr.r Contract Pnce ot Werk <br /> ��s.�lYl_.J�i 1 <br /> Proposed Use o(Building Contad Person (Plan Re�ew) <br /> Square Footage(It resider�tiel new conshuction, remodel or aqyRion) <br /> 1 <br /> Number of devices(If low voltage) <br /> D�aiPUon of Work lo Be Done' ��,` `��f�D ���� <br /> FEE <br /> CfTY OF EVERETT LOCAL SALES 7A7(COOE IS 310.5 �I'1_ � <br /> I hereby cerfily thaf I Aave read and examined itHs application and know!he same to be hue and �� <br /> com�ct. A!!provisions of faws end adinences govemirtg this type olwalr wifl br+complatod <br /> whether specifed herein or nof. T'he grdrtting ol a perrmt dces not pmsume ro glve aurhoAty to PERMIT# <br /> vio/ate or cancel the provisions of any oMer stafe or locaf law regulaNrtg construction or tha � I /���O � �j�/ <br /> perlormnnce of consfnicGon. 7nat f em autho��d by the owner of this property to peAomi 1he �� �[ b <br /> werk for which epplicebon rS made and 1 camply�+�ith the Ste(e Gontractors La�v l8.27 RCW and <br /> 2se.200 wAc. <br /> � � � ' � I <br /> 'ignature Date <br /> REVI$ED ND'IJ <br />