Laserfiche WebLink
ELECT�ICAL PERMIT AP�ICATION <br />P,Z c� <br />PROJECT ADDRESS <br />t �i h'1 <br />Own?r <br />Tenanl <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, [VERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — LL� �i t.+J -� �'�=�'2''" �✓<.2 . '�t� ;' <br />�, . <br />t' h,� ; 1 � c�ie.�c�+fe 9s `aJ eV�rG�';' `.aJrL � �a,� .: . <br />I> � ti�bC v� <br />� o 'r, � � 1 !Y- I �"% <br />C{�'-ol I"�� U� ��_'lti G'II I� 1 S. <br />Mail Address <br />Mail Adtlress <br />J <br />� vll��'TT '�Jp� <br />Ci�y <br />Ciry <br />q-oa-is <br />G �so�i'-o3-I <br />`j �• Z o I <br />SlalelZip <br />Sla(e/Zip <br />Phone <br />Phone <br />�� ..� n o � � a� �. <br />�I1�,.,O�,u��-�:6cZ'il-iC: �6 �>a�C i�r.� �ir-(E-�ia�.,� wr�. I�D�s i`!>>ISIZ 2oi2. <br />EleclricalConlractoi MailAddress City State/Zip Phone <br />i�'%' ;:���,� t z 3 �`� �� i � z-=' c; � y <br />State License Number (required) City v( Everett Business License Num6er (reyuired) <br />��J F t� �.fiti'I.C��� <br />Proposed Use of Building <br />Square Footage (If residential new consiruction, remodel or addition) <br />� <br />Number of devices (I( low voltaye) <br />�: <br />�, <br />Conlracl Price of Work <br />'1 �J C'kS2[jh1 i Sc -IW+9•;w21C� �v�,Jlirvv.,Q <br />Contact PersonlContacl Number/6mail <br />Description oNJork to F3e Done: �.� i��'«-11L���`ij�{,-� S•9v ir� � f(,il°�•`�LtYL�87�y- :i�- �;6� �T��<. � <br />`4+�'it1 Fn;�� izra:.�.�1 r�_v�>5 � `Z� G.�c.ti�rs <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />/ hc�eLy certily that I have rcad and examrned fhis applir,ation and know (he same to be true and <br />coriecL All p�ovisions o/laws and ordinancr.s governiny this type ol work �vil! be complefed <br />whether specilied herein o� nof. The gianfin� ol a permi( does not presume to yive aulhorrty to <br />violate or cancel fhe provision; ol any other;ta(e or local la�v re9ula(Ing consfruction or the <br />perforrnance ol construcfion. That l am aufhorized by the owner ol this pioperty to perlarm fhe <br />v�ork lor tvhich applicafion �.^. made and I comply �vi(h fhe Stale Conf�actors La�v 18.27 RCW and <br />296.200 Nl/�C. <br />r.rmsEooerocca�a �jl-�L � �, �i'`-� . . <br />FEE <br />� �'0, °� <br />PFRMi�tk <br />E �� o�l- nz1 <br />