Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 C[DAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — w/ t�� uJ.0 ��cr,? :;,d,z -��� 4/ <br />e�t.,�� ( �. L��rc�F-Fe.p.s �J �verc-f-� :.c.i�.-�� d �` � <br />� ,� 1 <br />� � � �, ���� <br />PROJECT ADDRESS <br />��IA i o �i�%' � �j��7 <br />Owner Mail AAdress <br />Grw,N��v���,; G:IY�s. <br />Tenant _ MailAddress <br />i�cll� �:�r �I.czm �c:. P� %•o k y3�1 <br />ElecfricalConlractor �daitAddress <br />l('„`•�Du�e x 3�� t,�t <br />S(ate License Number (required) <br />��ciar�li , �. <br />Proposed Use of Builtling <br />E v��t�'Tr <br />Clty <br />Clly <br />l�i t'-t<-va��� <br />Ciry <br />Square Footage Qf reslCenlial nev✓ construction, remodel or addition) <br />Number of devices (If low voltage) <br />�escription of Work to Be Done: <br />SAVIN� <br />l.-o. `/i2o( <br />Slale/Zip <br />Slatc/Zip <br />Phone <br />Phone <br />�A. °Ii1D��3 (yLi)82Z-zu�Z <br />State/Zip Phone <br />J"Zt (: I `I <br />City of Everell Business Llcensc Number (requlred) <br />� 25��00 <br />Con�ract Price of Work <br />I ,1 �71/.�Ci'�/l11J 'r5"C'NWh•tW+2� N.JII�.,LC l <br />Conlacl Person/,r.ontact Number/Email <br />_� �-n'n-1 �1 N S 1 R(1 rJ Ul 7�G�u l) S C_. c�t Y' . <br />i rs <br />CITY OF EVERETT LOCAL SALES TAX COUE IS 3705 <br />1 hereby crrti/y thaf I havo ioad and examined Oris applicaf/on antl know fhe same fo Ge frue anJ <br />correcL A!lpiovisions o!laws and ordinances goveminglhis fype o/work wi'I be comple(ed <br />�vhelher specified hercin ornoL The gr�ntinq ol a permif does naf presume lo give authontylo <br />violate or cancel the provislans of ony other sfnlc ar loca! law �eyulaGi�g constmcfion or the <br />perlormance ol conslruclion. Thaf l am authorimU by fhe mvnerof thls propeAy to perlorm fhe <br />work (or whlch applicafion is made and ! comply wilh (he Sta(e Confractors La�v 1827 RCW and <br />:96.200 WFlC. <br />r� <br />ncvU[o oBi04/SOH <br />��GrITS <br />f-[E <br />��D, c:� <br />� <br />PERMITl1 <br />E (�90�I��.°�� <br />