Laserfiche WebLink
OCT-12-2011 12:47 FROPI: <br />TO:914252578857 P.1/1 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EJERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425.257-8810 - FAX 425-257-8857 - www.everett v2.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />303o HoY`T <br />PROJECT ADDRESS <br />ZG10- Z,9 z. - q-Kg:x <br />w�t5SG0rnPPtJy /4107, AVCsu14e_/00 SSATTGE,wR99'101 <br />Owner Mail Address City State(zip Phone <br />W9tSScoMOary�f_ nyo I-toyT 4..VEt2£.7i <br />wra Ql�2ot _to4, 7 (z 97Ge <br />Tenant Mail Address r ._%C11 Statn2lp Phone <br />(�u�0.0traN5£cv¢�Ty 1-743 F%ZSTA.QE S. SEfJTr[-V__ W(% R&13L1 20(0-331�fo�Q <br />Electrical Contractor Mail Address C Clry State/Zip Phone <br />Gus.P-oSS z33)C S S ZS O <br />Slate License Numoor Contract Price of Work <br />_--t•2FLL AOAMS <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: I rt1 S7A L_W_ LOW V o LT F1kS0 F- A E 5 gZA O 1 U T f2 P r,lS m 1.7T <br />--r-o IS7tP'jG FAcf> <br />.'DOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 0105 <br />eroby codify that I have road and examined this application and know the same to be true and <br />rract. All provisions of laws and ordinances governing this typo of work will be completed <br />hethorspacttiod heroin ornot. The granting ofa permit does not presume to give authority !o <br />)late or cancel. the provisionsofany other state orlocal low rogWalingconstruction orthe <br />rdomianco of consPuclion. That I am authorized by the owner of this property to perform the <br />)rk for which application Is made and 1 comply with die State Contractors Lsw 10.27 RCW and <br />16.200 INAC. <br />0 LO <br />Signaturo Uate I I D; <br />l/ <br />