Laserfiche WebLink
E�► �:TRICAL P�R�VIIT APPLICATInIV <br />CITY OF EVIERETT PERMIT SERVICES <br />3200 CEDP.R STREET, EVER[TT, WA 98201 �"�"13 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org C 130 7- d� � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />'=, �;� � . G� ._1�f l'� i � <br />PROJECT ADDRESS <br />Ow�ler <br />�-> "',�; =I- '' I �I <br />Tenant <br />� <br />��-1S �/ i �-/ I�� <br />�� L- ��� (Ji' ir I L(�. �.. G'�%G�i `� L-� .:5:'lL�f%�- ���5i <br />Ciry StaielZip Phone <br />S L G' � �" <br />Mail Add•ess <br />, �' <br />; � %� � �� - <br />�^ l 'r'�, ;1 -� <br />; �ate License N6mber <br />, <br />_lI _j—_�� � f ( � � � � <br />Frcposed Use of Building <br />;escripiion uf Nbrk to Be Done� <br />�.� �[: WIRING !N NON-0�'t'ELL"J��S IS RECtUiF,EU TC <br />BE IN FQC:'�^�AYS, I�1C UR AC CABLE. <br />= �� <br />C; y <br />' \��•. ' ��. G. <br />Ci�y <br />I� <br />:�� ��%�i%- ������; <br />State/Zip ltr��, ���y��P1�pn�e <br />� S__ <br />�'(':1��'-f �f �`�� � �j? .. <br />StatelZip Y Phone <br />��;/ �_. <br />. y `�� ' <br />� <br />Contract Price of Work <br />�� <br />; ���( �� r ( :� � -i l�'I <br />Contacl Person (P lan Review) <br />(�., lt- [:' �= li�� <br />FEE <br />�V� <br />CIN OF EVERETT LUCAL SALES TAX CO�E IS 31�5 <br />I C�ereby ce�ti7y 7hat ( have read a..d examined tnis application cmd kr7ow fhe same fo be frur �.nd 1— I i��,,'1 _�` G1 <br />c�;irecL All provisions ollaws anc' ordinances governirg ;his type �! wor'.; will be somplefed C �I I <br />iY'�efher specr/ied herein ornof. 1 he granting o! a permrt does nol mesume to uive authonty to <br />v�o'ale or cancel the provisions olary o�her slata or locallaw rcgulatirt� c�enslruclion or tha <br />pedonnance ol construchon. That I am au:hu�ized by Ihe owner o( th's propeRy to p�eAorm the <br />work lor which applicafion is made and I comply wilh the Sfate Coniractors Law 18.. 7 RCW and <br />L� �� ' , � -- <br />;,� -� <br />