Laserfiche WebLink
— - — I <br /> I, <br /> ELECTRICAL PERMIT APPLICATION <br /> I CITY OF EVERET�i PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT, �NA 98201 � / <br /> 425-257-8P10 - FAX425-257-8857 -www•everettwa.org � �-�� J / <br /> iAPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> � i <br /> �,�� �i��-1 /-�1�� �� ` �� <br /> PROJECT ADDRESS <br /> �� t �/�- 9Q�'� [���.7U �� <br /> � . ,� ����� il� ������{'i�� �ivu�� (n ' /!v talelZip Phone <br /> ��5( <br /> Owner <br /> Mail Address City <br /> StatelZip P�ione�� <br /> Tenant <br /> 61ai1 Address Ciry ��J <br /> `� / / p p �' q �/J /, / , �jj 3g12 <br /> �l Y�IG�(I N/1 '°'C�i�`G��L r C�0 �� ��(J c J ) /�L !"�I.IG.L, ate/Zi� Phone <br /> Electrical Contractor <br /> 1Aail Address City <br /> �t �t � ��M'L` ��'� � Contraci Price of W rk <br /> tab:License Number I <br /> Contact P rson (Plan Revie�v) <br /> Proposed Use of Building � <br /> �- ��� )� <br /> Descriplion of Work to Be Dane: 'l�'� <br /> I . <br />� ,;: <br />�k q I <br /> 1 "1 I <br /> r';� � FEE <br /> ; i^�}' NOTE: BERN RACEWAYS, �v C R AC CAB�UIRED TO <br /> j <br /> i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi(y that I have read and examined this app�ication and know the same to be true and <br /> ��� co�recL All p!ovisions o/laws and o�dinances govemmg fh;s type olwork will be completed <br /> ' wheth.:r spea�ied herein or noL The gran6ng of a pe�md does not�rzsume fo give authorify to <br /> � violate or cancel the provisions olaR ofher stafe or local law�egulating construchon or the <br /> � I peAormance of constru on. Th am authorized by the owner of this property to peAorm the <br /> work(or which appOc n is m e and 1 ccmply with fhe State Contractors Law 18.27 RCW and <br /> � 296.200 WAC. <br /> �----- �- � / /-� <br />� � C��' G_ / <br /> Date <br /> � gna <br /> �w �. � <br /> u�µ-� �., , E � `CJ � C1 �� � <br />�� <br />�t: _ <br />�f 4 <br /> i�`'*�a�� — <br /> �6 . <br /> .�'4':�,'. <br /> i'..•G <br /> ��� —r.....�.�. .___� . <br /> � � <br />