Laserfiche WebLink
� � <br /> LECTRICAL PERMIT APPLICATION I <br /> ti ; CITY OF EVERETT PERMIT SERVICES <br /> ' 3200 CEDAR STREET, EVERETT, W.q 98209 <br /> 425-257-8810 - FAX 425-257-8857-wvvw.everettwa.org <br /> /2--Il-l� <br /> C 1412 —D�� <br /> v1i . �� n 1 •1 �"• - ' �- <br /> PROJECt ADDRESS I�� <br /> Ownet i Art�;lAddmss <br /> City SWIe12ip <br /> Plqne <br /> 1�\ - � <br /> , , •. ., c. - �, � 1N�1 f�1e,^r:ll re e lt � k ' ,�� . , <br /> Tenant v , r. 1; (Ll � g�� � <br /> r.ia�i nadmss� ��ry <br /> ' Sfatc2p Phone <br /> .L �t�'1Uir�� 'u� ' - fe�i �s'Ft:.� l���� ..'35' C LS Q,�.:� � ... c � . <br /> EleUncalCanhaclor ! �.aii,�tl�s, L� c« a � uJl )b��3 <br /> � �'�' Slate/Zip Phnnc <br /> ll� '•�� S Ssl�,�/ � <br /> State License Number(requimd) <br /> 1 Ciry of Everett Business License Number(required) <br /> � p� i <br /> ,,, �� t-�,,, ' i �G437, <br /> Proposed Usc of 9uJdm� <br /> ' CoNrad('rice ot Work <br /> I I <br /> 1 i <br /> Square Footage(II res�r,e 6al ncw construction, remodel or adAitlon ��� �� �� , ��F�� � ���� <br /> ) Contact PersonlContact Number![mail <br /> �.�3- �•�/-..i5'Y.� C'.,l1 <br /> I a�_�.. �-�%/- ld�1G r;;�-��r- <br /> Number of devices pf Iow o�t�ge) ' y. � �y���1, `zc,�` <br /> f.Il1:L.l : �YlilC L .i ti r ^L � <br /> Descnption of Work to Be one 1_Lj�-��f( ��. c � � �� ��� , � � j�r 4�a, <br /> i <br /> FEE <br /> CITY pF EVERETT�OCA �SALES TAX CODE 1S 3105 � /--i,1 <br /> O L�J <br /> 1 hereby cerl�ly thaf I h�ve �.ad and czommed fhis applicahon and know Iho same lo he fn�e and <br /> :'Om_�r.t. A!!pmvis�ons o(!a �s and ordrnarces goveming(Bis lypr, o/wnrk will be compfeted <br /> whr.fher spr.cified herein or oL The g��rG;�g ol a peirrtrf doPs not piesume!o givo avfhon !u <br /> Nol:�te ar canccl lfre provisr iis o!any olher sfnfe ar local law rogulafing conslruction oNhn �'ERMITk <br /> perfnrmance of construclio � That I arn aulhornod Dy Me owner ol this crope�ty(o perloim the E ��-! 1 � _/'-�Q � <br /> �vork!or whrch appiicafron i. made anr!I camply�viUi llro S1ate Conn�cfors Law f8.27 RCW and � � IJC� <br /> 29G 2C0 WAC. <br /> t <br /> �, , <br /> �`%C'� v k � `: , �� /� - /U - / y <br /> Signatum �� Dale <br /> NEV�:f[lOM1.6'lOIJ i <br /> -- ; ----- --1 <br /> ll-d bSClLf8C9Z 4�olsuiels�(Soni�r.nouu! dh0�E061OL �00 <br />