Laserfiche WebLink
p1248 P.003/006 <br />11/27/2012 21 ad <br />ELECTRICAL PERMIT APPLICATION <br />CITY �F EVERETT PERMI'T SERVICES <br />3200 CEDAR S7REET, EV�R�TT, WA 98201 <br />A25-257-8810 - FAX 425-257•8B57 — www•everettwa.org <br />APpLICATIONS ARE ACC�PTED FROM 8 AM TO 4 PM <br />�00 /v1a ��%%�za ��vAP — <br />pROJECT ADDRESS <br />' ', .� . ' <br />7��i��y /�r''n �r �90 7 • �.�ry l _ �l f � <br />Owner <br />Mall Address ��ty <br />Tenant <br />Mail Address ��ry <br />� v- �'.� r W'7e�a �c._ ...�- . <br />E octrical Contrador Mail Adaress �' , <br />.��L19.vss � v z � P : . .. �-. �. . <br />State License Numhc� " ' <br />/) P�' _ ...._... <br />Propos�d Use of 6uilding <br />Description of Work to 6e Oone: <br />� <br />NOTE: ���N �CFW YS M�C R ACIC_A[3 nUIRED TO <br />CITY OF EVERE7T I.00AL SALGS TAX CopE IS 3105 <br />1 hereby cartify thaf I have rend and examinedlhis applic, <br />coirect. All provisions o(faws and ordinances goveming <br />whefhar speci(ied heroln or. not. Tbe grantin� o( a permit <br />performance°o con� Puciion �T ef 1 am autho�ied by thi <br />work Ior wh.lch application is made nnd I comply wlfh the <br />296.200 WAC. , <br />i _ _ ,� , _ —_---- <br />and <br />afzT 7/a-; <br />9�a.7s� — <br />SWte21p Phono <br />S���iP phone <br />� �� 9�'zo/ �/1� �2� z/6 <br />Gty State2lp Phone <br />,�G�r_ <br />� <br />Contract Price of Wo� <br />s <br />Contact Person (Plan Faview) <br />, . . .. ,. . <br />to be trua and <br />ompletad <br />� authorrty fo <br />�n wthe <br />i P27 RC W� end <br />1 <br />FEE <br />�O�> <br />�►z�l-lg( <br />