Laserfiche WebLink
ELECT'RICAL PERMIT APPLI�;ATION <br />PROJEC'f ADDRESS <br />1�CJ�'� <br />Owner <br />Tenant <br />CITY OF EVERETT PEFtIVIIT SERVIC�S <br />3200 CEDAR STREET, EVEF2F iT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everetlwa.org <br />� 5 Cx> <br />Mail Address <br />tdail Address <br />a (f �,ucc.�� �.A � /�6 � <br />Gry Slate/Zip <br />City SlalelZip <br />Phone <br />Phonc <br />Q�o-1--�DN o✓► 2 a�o�-co (n S� Av'f. S 1�U4- t�°�" iSD3 � <br />EleciricBl COnlfactOf M11ail Atldress City Slate2ip Phone <br />�6��-��33� P <br />Slate License Numbe <br />Proposed Use of Building <br />�/ � <br />Square Foola3e pf residential new conslrudion, remodel or addition) <br />� <br />Number of devices (It low voltage) <br />Description o( Wark lo Be Done: <br />L <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />� o'� �$ <br />Contract Price of Work <br />�c�_ �2�398-�vs`t <br />Cont ct Person (Plan Review) <br />I here6y certily fhal 1 have read and ezamineAlhis applicalion nnd know Ihe seme fo be We and <br />correcf. All provisions ollaws and ordinances goveming this type ol work will be cornplefed <br />whe(her specified hemin or noL The granting ol a pemiit does not presume to give aulhonty fo <br />violafe or cancel (he provisions o/ any othc-rsfafe orlocallew 2gulating consWc(ion or Ihe <br />pedonnance ol cons6uclion. T/taf 1 anr a�rthorized Gy (he owner ol this property (o pedomi the <br />work lor which applicalion is madc and I comply with Ihe Sfatc Confracfors Law 18.27 RCW and <br />296.200 WAC. <br />REViSE� 120'U <br />FEE <br />�� ov <br />PERMCf# <br />E I �{� �-�5� <br />