Laserfiche WebLink
�lay 21 13 09S5a Coie Electric LLC ��0-668-0608 F � <br /> _ --- �l <br /> I <br /> ELECTRICAL PERMIT APPLICATION <br /> ; <br /> CITY OF EVERETT PERMIT SERViCES <br /> 3200 CEOAR S1RtET, EVERETT, WA 98ZD1 <br /> 425-257-08'10 - FAX a25-'s7-8857-vrww.everettwa.org <br /> 5 —ac—� 3 <br /> �i�o S-1a0 i <br /> ��i i o n.u..,,« D: ,���,�tr, �✓A �t��3 <br /> PROJECT ADORESS ' <br /> Lr.c: Pc;-i� Z_ 7�1�(� �'...�.,e� �: cve .c.� Wi4 `lv'u_' 'J 'iL> �S'SU-vc�`1 <br /> Ownet 61adlWdress Ciry Slalu/Z�p Phonc ' <br /> T9nant ht�ilAtlaress Gly �ltc�Z'�p P�oce <br /> L:.Ieticc{�,cL1-G PI.� 3r� �1i.70E �c.-.w��:e Wr� �l9i.�:=Y, 72'� YYS-��'iy ' <br /> Electnqt Conttactor My'Atltlress Ciry Stete2�p Pnone <br /> Golcc��- �i91G� � Z70U <br /> Stato License Number Conlract Price of Work <br /> � <br /> I <br /> IProposed Use of Bmkting Contact Person (Plan Review) <br /> I� Square Footage pf resitlenlial now conslrudion,remodel or addition) <br /> � <br /> INumber oi devices(If Iow voltage) <br /> Descnpcion of Work to F3e Done: Z�V ��"�0 5C��•�- � L�"�5 � ___.. <br /> FEE <br /> I GTY OF EVERETf LOCAL SALES TAX CODE IS 3105 �C�C'U _ <br /> i <br /> f horaLJ certi(y tbaf f have/ead antl axnminod lhis applicaAon anJ know fhu same to be true and <br /> connc!. !V!pravisions o/lows ond cnfinancos yovominy�his type o/trork will be complelad <br /> ��heUrer specified heivin or na7. TT�e gmnting ol n pe�mif does not presume[o give aufhonry(o PERMIfY, ', <br /> �Ta7a(e ur cancel tlre provisicrrs ol any otherstato orlxaf!mv regulah'ng caoslrucfion orlh.e ->/ � '7(' � , <br /> peKormance o(construclion. Thaf 1 am auffronled Ay Orr. owner ollliis propery to perfom�the E I ��1 v 5 �" �Ll/ , <br /> a�o�k for which epplicafion is mndz and 1 coo�ply with!he State ConM✓ctors Lew 18.27 RCW and <br /> 296200 WAC. � <br /> I <br /> ;�-��<-� �a��- 5� �r � l 3 � <br /> Sipnaturz �ate <br /> �1r5hp$Y!YI] I <br />