Laserfiche WebLink
ELECTRICA�. PERMIT APPLICATIO�! <br />PROJECT ADDRESS <br />��� — <br />Q�•mer <br />Tenant <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEhETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — W w uJ -C ✓u�'f`� w2 - y� ✓ <br />ek.�.� I�. L✓ere-F-Fe ps ��v���f-f w� Jn✓ <br />i <br />L ) n�9E � <br />� <br />P� �`x I �j`j% <br />nt�n nadr�,� � <br />C�:nNO'J�Ew (�l?'i <br />i��ut.nf �lc��ZiG <br />Electdcat Contraclor <br />�dall Addre;s I <br />i <br />Po Go ;c �, `I3 � <br />hlall Address � <br />EvC'l ;c'1r <br />ciry <br />Ciry <br />l�� P-l��aN� <br />City <br />1�'��'��Du�E � 3�'� ��i <br />State Ucense Number (required) � <br />f,�Qf�i�llk�s i <br />Proposed Use of Bwiding I <br />Square Foolage Qf resldenlial new consfruction, remodel or addllion) <br />i <br />i <br />Num6er of devices Qf low voltage) j <br />Descripllon of Work to Be Done: <br />E�sio -09/ <br />!� � /� "�.S <br />L.:r> c� �j 20 I <br />StalrJ�p <br />StatrJZlp <br />�4. `I°�D��s i`1ls`� <br />StatelZ(p <br />Phorc <br />Phonc <br />Z2-2u�2 <br />Prone <br />D'i�- C 1 y <br />Cily of Evere�t Buslness License Number (requlred) <br />� ��, � i <br />Contract Price ol Work <br />T1'C-v�rn,� rSo--nw�.,W+rr.re.Nuti�u,� <br />Contact Person/Conlact Number/Emall <br />r SAviN(, (, <br />S � L G� /L/�„� <br />CITY OF EVERETT LOCAL SALES TAX CO�E I I 7105 <br />1 hemLy ceriily that / have �ead and examined flJs application and knov✓ the same to be true ond <br />corn:cL Al! provislons ollaws and ord/nances goveming this type ol worir will Ge completed <br />whether speci0ed hemin or not The granfing ol a pwmil does not presume to give aufhcdty fo <br />violate o�cance/ the prov/slons olany others(ate orlocallaw iegulating consWction or the <br />pe�formance o/consfluction. Thal / am authodzed by fhe ownerolth/s property fo perlomr fhe <br />work for whlch npplica0on !s made and 1 comply wifh fhe Sfate Contracfors Law 18.27' RCW and <br />296.200 WAC. i <br />OG <br />aeeue�asrosvoro �j��GL -TD � [: ('i <br />FEE <br />� 5D,°% <br />PERMIT# <br />E �r 10— D°l � <br />