Laserfiche WebLink
ELECTRICAL PERIVIIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT. WA 98201 <br />425-257-8810 - FAX 425-257-8857 — vn��,v everettv,�a org <br />`�7i�.� GCs�`�w+� Z�• <br />PRUJECT ADDRESS <br />`/z5 - 3'� S <br />1<4��,.. S�'�.-B_v�1�..��;�, r,r (z�������� ��r�• y�.��� 36��_ <br />OWn2f Iv1ai!Address C�ly Sta�e2�p Pnoce <br />Tenant <br />�dad Address <br />Gry <br />Statel2ip <br />Phone <br />(�7 • � rc-� ��[_c-�-�n� � (qi3 Z 97� s. �r,,' �'Ir�� ✓,ur Ua. 9�r z �O �Y o- �-��'•� <br />Elec�neal Conlraclor h7atl Adtlress Gty Stale2p Phcre <br />C�E e_-! 47C !� / <br />Slate License Number (reGuired) <br />Proposed Use <br />Square Footage (H residen6al new construction, remodel or aCddion) <br />Number of devices Qf low volta�e) <br />� I <br />City o[verett Ousiness Lirense Number (requ�.red) � <br />� ` - <br />CoNract °rice oI Woik <br />Contact Person/Contact NumbedEmail I�I <br />Descnption of Work to Be Done. ��_j�_���w��L ��"�-��`"'� ' <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby r.ertdy thaf I hav� read and exarnu�ed tivs app6cation and know the same fo be fnie and <br />coned All p�avisions ollaws and ordmances goveming Ih�, type o/woric �vill bc complel2d <br />�rhefhcr specJied herein ornol. Thc granhng o/a pemiit does nof presume to give au�lior�ty fo <br />violafe orcancel fhe prov�s�ons ol any ofher state orlocal Imv regulahng con;tructior, or Ihe <br />peAormance o! consfruc(ion. That 1 am aufhonzed Gy the on-ner ol this property to per/o�m the <br />worN (or which app6cafion is made and ! compty with fhe Sfate Contrac(ors La!•+ 18 27 RCW and <br />296. 200 WAC. <br />�� r�5 —/�/ _ <br />SignaWre Daie <br />FEE � <br />�O � <br />p[RM]T# <br />E ��Io- ��`� <br />� <br />