Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />PRbJECT ADpRESS <br />�F�10 <br />Owner <br />Tenant <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — w' to ui -f t�Lr�`i-r' w�Z - Jv �' <br />Ch.�,-, I'- GdCrC-I�eFS � EVG'Lt'{' (d2�yG✓ . <br />J <br />u�h�� <br />Po �i�F I �j��' <br />tAail Address <br />G14�r`�)V�FvJ L<I?'� <br />��l�I�LA� �LZ�IZIL <br />MallAddmss <br />P� >oF �I��� <br />�', L 111,.:� �,.�P� <br />City <br />Ciry <br />t�� �-��N� <br />�1S/G" n � <br />lo - a�_� S <br />��ZO� <br />State/Lip <br />State2lp <br />Phone <br />Phone <br />�%4. `I°✓D��S �`fZi]E22-2ei2 <br />EleclncalContrador �dallAddress City Stale/Zip Phone <br />�r�,.��u,.E z 3�� �,-1 �v �i y <br />State License Number (required) City of Evemtt Business License Num6er (required) <br />i�Fr�,^a-rt�-n,'t� � 2� .°.�i <br />Proposed Use of Building Contracl Price ot Worh <br />Square Footage (If residen�ial new conslructioq remodel or adCi!ion) <br />Number of devices (If low vol�age) <br />-IS-C-u�s�nn� TS�t-rvwg..W+��n�,.����u,c <br />Contact PersoNContacl Num6er/[mail <br />Descriplion ol Work to Be Done: �� �n"��� i7"L�j,`j 5"��� iN t; Q,c-{�u�t�l^��E7�t- 6'� L I(,N7 S � <br />�n�{ �f'IS 1 '4�:JL^E F�_L�S I �/ L11.L(iN��S <br />� � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certi(y (hat I have �ead and examined fhis applrcatlon and kno�v fhe same (o be tiuc and <br />correcL All provisions o//a�vs and ordinances goveming this type ol �vorfr will be cmnpleted <br />�vhelher speci�ed herein ornoL The granting o/a pe�mif does nof presume (o give aufhonty to <br />vio/ate orcancel the provisions ol any other sta(e orloca/ law regulafing consWcfion o�(he <br />peAormance o(ronsfrucfion. That 1 am aufhonzed by fhe o�vner ollhis propeAy !o perlorm the <br />�voiir (or whicb applicafion is made and 1 compty �vilh fhe Sfate ConUactors La�v 1827 RCV✓ and <br />296.200 WAC. <br />R£VISEOOBNSQOta ( `L '� /_ (�l. /1 <br />—_—.—. __� �- --- (.� 1 / 1 _ — <br />FEE <br />�}� cn 00 <br />"J ll <br />PERMIT# <br />E151D-I'i� <br />