Laserfiche WebLink
- —� <br /> ELEGTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everetriva.org f z/ �a� <br /> C-��(�z���� <br /> l ��rx 1 rn.cNvi u C.�-,c,�,4� na,t—��w� <br /> PROJECT ADDRESS <br /> 1. 1�,1tv j, �t�n:�s �p�Llll h-l.lw�ll Py pkwu S,��c�.c�dc t.� _�14a-()b �11�i.'�-15.N3UD <br /> Owner Mail Address City Slate/Zip Phone <br /> i <br /> Tanat�e Mail Address City Stale2ip Phone <br /> ,�p r,��rs.��.,o r�-i,'� '1 o5t o �S �lt��tiS+- �,�- �,�� �i Ss03;�., �,,r� R��. <br /> Electrical Contraclor Mad Address City Slate/Zip Phone <br /> S�t�a�10�-�-e�J (���� <br /> Slate License Number(required) City of Everett Business License Number(required) <br /> �DMrvWLCt'c,.0 �D( Lo� �i �� <br /> Proposed Use of 8uilding Conlracl Price of Work <br /> ���i_,�1 �•5�,�1�_Zlllo—�4_U�c+�S <br /> Square Foolage (It residential new construction, remodel or addihon) Contact PersoNContact NumbedEmail <br /> Number of devices(If�ow voltage) <br /> �escription of Work to 8e Done: �Yl C-�i l�l �,( f,�A �(�A� �-rC-�-u."� -�r �CLV1 l�UW AJ�-� I <br /> � v�f-L.� �U v.£rnav�Q� v-c,l o[a�l,i✓� d ; n SI�ul11��uv� � rvi.,S r . P �.�L-f,�;��..D�.S_ <br /> �.2.✓-�-c�r.:�, � -1-h.e ��iv.r �t_,1-4i ur�-eea b�o�,e cf wdrk. . <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 v� ��� <br /> 1 hereby cerfily Ihaf I have read and examined this applica(ion and know fhe same fo be frue and <br /> � � <br /> � carrecf. All provisions ollaws and nrdinanr.es governing fhis type ol work wdl 6e complefed <br /> � whefherspecified herein ornoL The granfing o/a pr.rmif docs not presume lo give aufhonty fo P[RMIT# <br /> violate or cancel fhe provisions oJany ofher sfafe cr locallaw regulating corstruction or fhe � I � I �! I O� <br /> peAormance o/consfruc(inn. Thaf 1 am aulhonzed by fhe owner o/fbis property fo peAorm fhe <br /> work lor which applicafio^ ��made and 1 compty wifh the Sf�fe Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> SignaWrc Jate <br /> utmsm onro2ao+a <br />