Laserfiche WebLink
:� �.. , ._. <br /> ;; <br /> ELECTRICAL PERMIT APPLICATION I <br /> CITY OF EVERETT PERMIT SERVICES ' <br /> 3200 CEDFlR STREET, EVERETT, WA 98201 � <br /> 425-257-8810 - FAX 425-257-8857 -v,nvw.evereth.va.org �� <br /> t � �`�� � , �/ //� �., i <br /> ��` � <br /> PRO�ECTADDRESS ��^ �Q�p <br /> ,/ l0/Z`// <br /> �'!-�-�( �"���I �/"UI G�S u�GC/'P/�` �Cc n-/ �o��o I <br /> Ownef M17ailAddress City Sta;c�Tp Phone ! <br /> �-�..-o �h�� S'���-P �s o���-� �.�s _-ya?- <br /> i enant ldad Address Ciry StatelZip Phone <br /> —P S �n ��,r ��� : <br /> Electrical Coniractor Maii ddress City StatelZip Phone <br /> State License Number Conlract Price of Work <br /> /.-e�.� �OU'�' ��'P I <br /> Proposed U�Building Conlact Person (Plan Review) , <br /> Square Footage Qf resideMial new conslruction,remodel or addilion) <br /> I <br /> Number of devices Qi lorv voltage) I <br /> Descrip�ion of Work to Be Done: ��/J //�l'/C�P/' /,L��/`-P __ <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 /'—D O6 � <br /> �� <br /> 1 hereby ceriify Ihat 1 have read and exam%ned this application and knmv the same to Ge true and <br /> correcL Al/provisions of la�vs and ordinances goveming this type ol work�vill be completed . <br /> �vhelherspecified herein ornoL The gran(ing ola pemril does nct presume to give authonty to PERMIT# <br /> violafe orcancel the p�ovisions ol any othersta(e orlocallav✓i2gtdating conslruction orfhe . <br /> performance of consfruclion. That 1 am authonzed by fhe owner or this pioperty fo pedonn(he E (3 t D - ! z� � <br /> work Ior which applicafion is made and 1 compty:vith the Slafe Contraclors Law lti.27 RCW and <br /> 296.200 WAC. � <br /> � � � /��1�.�— <br /> gnature Dale <br /> I <br /> I <br /> . _ =nr�.;�ii _ . _ _ _ __ _ _ _ _. _ . _. _�TT� <br />� +,..� ]�. �� } ,ys yz � � r _?:� � e�-Y_.._�._ 4u,G.a �`n�.`i <br /> �r i��r4'1�1 II � '+'.s: L� ���it4 � �!*`� � _ , �. �,.��i���'-� .� ..�' �� �'� Li:. � �7, <br />