Laserfiche WebLink
� <br />� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />°_'00 CEDAR STR[ET, EVERETT <br />425-257-8810 - FAX 425-257-8857 - <br />Ch.n�� ('. �✓2re-F-Ft�iS � t,VGrGt"�Y <br />, ..,.. <br />�-' -5 % �'i ��% � <br />PROJFCT ADDRESS <br />��F� <br />Owner <br />Cf��i��?ViEin: (Cl <br />Tenanl <br />ro 8�;� i 5� <br />Mail AJdress <br />Mail AtlUress <br />, WA 98201 <br />w/ �i uJ . E✓r.a-£.'f'r` WQ <br />w�- J v f <br />E ve�t.�`iT L-T. <br />C�ty <br />Clly <br />�0 ✓ <br />7 -�-'s <br />� �so � ��3 3 <br />`j�Zol <br />Statdl_ip <br />SIaIC/Zlp <br />Phonc <br />Phone <br />f V��v u�r ���Zi12iC: �a io;c `i°r�� l�i P-ti-�.n��� L..)�, °I ✓C �' 3 <br />' �`ILi)E•ZZ�2ui2, <br />Electrlcal Conlraclor Nail Atltlress City Slate�Zip Phono <br />�f�'�.�����r x 30� ��i <br />State License Number (required) <br />I�PI�(1:Ti'li.�� <br />Proposcd Use of �uliding <br />Square Footage (II resldential new conslruclion, remodel or addition) <br />Number of devices (II low voltage) <br />Dcscdpllon of ✓Jmk lo Be Donc: <br />�'i,L � 1 y <br />Cily o( Evetett �us?r�ese Licensc Number (requlredj <br />�. <br />Contract Pr1ce ot Work <br />., <br />TS Eu�n-sin� rs�-nw�a�.,�rs.� ��wu�u,� <br />Contacl Person/Contact Number/Emall <br />savr�� <br />�?n�n� Fnr+S � Rn�G�" ruc9S 1� 3 C IrZc•ui't1 <br />CITY OF EVC-RE7T LOCAL SALES TAX CODE IS 3105 <br />! hert:by certdy fhaf ! have �uad ��nd examined (his applica(!on ond kno�v U�e same (o be fruo and <br />corrr.cL Af! piovrsions ollaws and ordinances govem/ng fhis fype o1 work �vill6e romp/e(ed <br />whclher sp=ci(ied herein ornoL The gianGng o(a permif docs nol piesume fo givc aulhority to <br />vio/afe orcancel (he provlslons o/any ofher sfote orlocalla�v rt:gula(ing con;fructlon or fhe <br />perlormance of cons(rucfron. Thaf 1 mn aufhonzcd Gy thc owncr ol fhls property fo pcAomi (he <br />irwk lor �+lllch applicafion i; made and / comply rvilh (he SWIe Confroctors Law 18.?.7 RCW and <br />29G.200 IN�C. <br />D� <br />nni�coo.+ma:�oie <br />-- ------� � L L 7U__L l-t %�-- <br />� �G;�-r-t <br />FEE <br />�O �� <br />PERMC�fi; <br />Ei5o7-133 <br />