Laserfiche WebLink
��ia <br /> ;- ------ <br /> ---_ ---- --_ _ __ 1 <br /> ELECTRICAL PERMiT APPLICATIOt� <br /> CtTY OF EVERETT PERMIT SERVICES <br /> I 3200 CEDAR STREET, EVERETT, WA 98201 � <br /> 425-257-8810 - FAX 425-257-8857 —wvrN.everettwa.org I <br /> a-�3-�3 <br /> APPLICATIONS PRE ACCEPTED FR�7'N 8 AM TO 4 PM <br /> � !3D��-085 <br /> 10�- ���� � �I�.��, -��-,.;� �;;��,��,.�� �1�,��- `����� <br /> PROJECT ADDRESS ! <br /> I � � ��• �' �y <br /> I ` 1 , y�r� N-II��"1���,� %;;:,�r�-�,-4- lrJ,4 °I;;�,-..c� ,c;��;� � ��`i; <br /> � �' 1,� �. I"r`�� IC'� <br /> Ovmer Mnil Address �� City State2p Phone <br /> `/�i- /li�i���'>_ l�y�`�.�1: uF� ��!� � ` L�)i�- '2"-';<1C.•� -�57 <br /> �TenarR ldailhdeross l C�ty Slala2ip Phone <br /> L}L> <br /> � � <br /> 1/. :. 'A G � l A �,. (i�4.�� t.�:ur. -)��i> <br /> �_4 0• ���- ; �L) �Z.�f Vl;c.�l����G7 ,: _rrd�trx Z VL5.1' � � c.� r <br /> ' Fie ncal Cont�acto� Mail Address � Gity StalclZip Phone <br /> �r—CI� pi� <br /> �'�1� I ,�c��'�,!`,I"1�'Z <br /> Stato License Number Contract Price of Werk <br /> -� � �� �� j) �V1�1(aC� � ti %>v1 <br /> ��C`��c J:�� 1 i;�� <br /> Praposed Use of Building Cor.tact Person (Plan Review) <br /> ,,� �� <br /> Square Pcotage(If residential new wnstaUion,remodel or adtli6on) <br /> DescriptionofWorktoBe�one: �� � i'��(� f0 '��41�1' � ��� ��1���J'��l\ P �� p�!;{l(c-.� <br /> \ <br /> "y -� � ,�'' '1�� �">�Ctc�' I'i�lD✓��- c� � `r�'� '�'C'��� ('i-,�r,�:��:�. <br />_� <br /> � �,� <br /> I� NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> IBE IN RACEWAYS. MC OR AC CABLE. �� O� <br /> IICITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that I have rr.ad and cxaminud tliis applrcation and knosr the sarnt�fo be truo and �� �T � O�� <br /> Iconect. All provisions ollaws and erdinances govemmy tlus type of�vo;k u�ill ba complefed �J <br /> �,�hether specified he2in or noL The 9ranting of a permd does not resurne to 9ive aufBonty to <br /> violaile o�cancel�he prowsions o(any ofher sla(e or locallaw ieguPfmg consfrucfion or the <br /> ;'. perlormance at consPruction, That I am authonzed by the owner of th�s property ta pedorm fhe � <br /> �,io.k lor which application is made and I comply with the State Confracters Law 18.27 RCW�nrf <br /> �� 296200 WAC. <br /> i /%"����"��� ��.I ��J� i �_ <br /> �� <br /> 'I - �Sipnature Dat <br /> _ . .__.___.—.. <br /> uc:� <br /> � ��I,c�; v�o�� 'LCl�JInoE09! QI�o-tl�Z t !o l a6ed �°1 <br /> ar ...; <br /> -- -nr _ � . , b...�?' . , ,;, <br /> _ , .,� .,. . , . ,� <br /> �: <br /> ra. <br /> � � <br /> � '.}: .> <br /> ->�. <br /> _:.�.. .. . . : _ ,,. <br /> . <br />� <br />