Laserfiche WebLink
ELECTRICi4L PEhMIT AI�PLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettvda.org <br /> APPLICATIONS ARE ACCEPTED FROhI 8 AM TO 4 PM <br /> -`p�s � (LpCI<,_. f-��L�/�- /qvri <br /> PROJECT ADDRESS �f LS <br /> � �� j37 -Zo� <br /> -� ?`Z>3'� 1�� � N �L S�.., G=v�-(vi t I �r-1 A (�2 <br /> (L1-'� '/ t 5{a ' A �"' ' <br /> Owner Mail ACdress <br /> Ciry StatelZip Phone <br /> Tenanl Mail Address <br /> Cily State2ip Phono <br /> �C�N N +�1�-_ - <br /> Efectrical Contreclor Mail Address <br /> City SlalelZip Phone <br /> — Contract Price of Work <br /> Slaie Licanse NumL�r <br /> �-- <br /> - Contacl Person (Plan Review) <br /> Proposed Use of Building <br /> Descri{�1ion of Work lo�e Done: I L�- C U'v N��-j �-�"� Lr(�-� L�-� ��Tr�'— � <br /> �-��L n�E Nr��3 -1-_T.,t3 L �-� n-L� i�s - <br /> FEE � <br /> NOTE: BERN RACEWAYS MC OR AC CAB 4UIRED TO � <br /> � CITY OP EVERETT LOCAL SALES TAX CODE IS 3105 _ <br /> 1 hereF,y ce�ti(y fhaf I have resd end examined this application mid knoro fhe same to be true and _ 11`1 _ + � � <br /> � conecL All provis�ons o/Imvs and erdmances governmq fhis type ol�ti�ork n�ll Ge,completed <br /> u�helher snecihed herein or,nat The grantinc�o(e pernuf does net �resu,ne to;,ve au(honty fo <br /> violate er cancel Ihe provisions o/any ofher state or local la�v regula6ng oons�iucficn or Ihe <br /> pe�formance o/consfrucfion. Tha(1 am aufho�ized by the owner o/ff�is property fo perlonn(he <br /> �vork(or which applicufion is made and I wrnply�vifh fhe State Contr2cfors Law 18. ?7 RCW and <br /> 296.200 WAC. <br /> {j��� /��_---�— 1/ 1 ? �( -- <br /> � ate <br /> SiflnaWre <br />