Laserfiche WebLink
ELECTRiCAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SEP.VICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — �v�.�rN.evereth•�a.org <br />� Oo `� �r�.rz,5 D � <br />PROJECT ADDRESS <br />C%,r �? T�.,-��<.7�' � <br />Owner tdail Aedress <br />Tenant <br />tra�l Address <br />C�ty <br />Gty <br />I .Zn�2A- �r�t�,ui k'I[� v2bG(� ��r�/�,�c✓U%_ <br />FlectriealContractor �daf.ltldress <br />-1-nTe`'Si �u� r�� <br />. Sate License Number (required) <br />' C�le��a�..-1-,.1. <br />' �'�cposed Use ol Dwlding <br />����i <br />�quare Foota pf residential new construdion, remodel or additi�n) <br />of devices (II low vol�age) <br />Ucscription of Work to �e Done�. N�"� <br />C�ry <br />� <br />jl�u 70( 9�f8S I <br />Slate�Lp Phore <br />State/Zip Phene <br />— ��.1fF9�� yL NZs�>v�a'�U <br />State2�p Phonc <br />l �t rn�cr.�' S5 <br />CRy of Evere Business License Number (requiied) <br />y So� - <br />Conirect Price of V�brk <br />/�t� �( 2S 5 �}(, �53� <br />Contact PersoNContact NumbedEmail <br />���Q . I�-m•5ti Qe.u�'�n�. �le..� <br />�un��" � 1�C�,J ��nkc. — <br />u <br />--- - � - --- - - i <br />FEE <br />I CITY OF EVERETT LOCAL SALES TAX GODE IS 3105 ��.� <br />I Irerebv certrly (hal I h�3ve read and exammed fhis apphcafion and know fhe same to bc We and __ ___ .. _-- _— ! <br />coirece All provisions olla�vs and ortiinances goveming (lus type ol work �vdl be complefed -- � <br />whefhe� specified herein or noL The granling ol � pennif dors not pmsume �o give aulhanty fo PERh11Tk <br />wol,�(e or cancel fhe �rovisions o/ an other,(afe or local la�v �e Wa(in consln�c(ion or Ihe I "� i <br />per/onnance ol consfruclion. rhaf I arn authonzed by fhe owne 90l thi �property 10 peAonn fhe E/��Q �'(� dl i <br />work !or wfnch applicafion is made and ! comply �vith �';e Stale Conhacrors Law 78 L7 RC W and __ _ i <br />296200WAC.�� � �i <br />. . _ .. . ..: „ <br />