Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />i 3200 CEDAR STREET, EVERETT, WA 98201 �/ y <br />425-25'1-8810 - FAX 425-257-8857 — www.everettwa.org ��—b <br />02�0 l ��I�e,�(ler <br />PROJECT ADDRESS <br />Tenant <br />�- chu���, a�o i Ra <br />h+ad nddress <br />5 �� _ <br />G1ail AdUress <br />c�s}�e��s Ob ffc <br />�Atldress <br />(�G��N���s�� <br />Stale License Number (required) <br />Prop^sed Usc of Bwldmq <br />Squa�e Pootage Qf res�dentiat new conslruction, remodcl or adAinon) <br />Number of dewces (If !ow voltaqe) <br />Gry <br />C �`'��_°<<z'� <br />Slaic!I�p PhOne <br />-- �o�c�so2 —0�%� <br />City S4veiZip Pnonc <br />Gty <br />Sla•c!Lp <br />Phone <br />Ciry ol E�re t Busines � icense Num�e� (reyuved) <br />•�• " <br />Contract PriCe o1 Work <br />�la�'e.Sace 6s <br />Contac� PcrsoniCornact NumbenEma�i <br />�2caPerM�-�-sQ berry5i9��sys�fen�.c <br />Descnplion ol Work to Be Done. _ 7�%�� v��� �Q`� N_(�/✓1��P(JL(KQ— ���j��% __._ <br />� � <br />�o�A�r fctbe, ��ql�lih� � <br />CITY OF EVERETT LOCAL SALES TAX COOE IS J105 <br />I he�eby cen�ty p�af I have read and ez�mmed fhis �pphcahon and know (he same fo be hve and <br />conecl. Al/ provis�ons o/ laws and ordinances governing fhrs type u! work wdl Ge completed <br />N�hcUier specdred hcrcin or not. Thc gianfing o! a permd does nol presume fo give aulhonfy lo <br />violafe or cancel Ihe provrsions o! any ofher slale or local law regulafing conshuCfion or Ihe <br />perlormance ol construclion. Thal ! am aullrorrzed by fhe owner o/ flus proper7y to peAorm fhe <br />work lor which application is made and 1 comply wifh the Stafe Conlracfas Law 78.27 RCW and <br />296.200 WAC. <br />an isen nane:r�a <br />ree <br />50� <br />PERh1ITu <br />E jy I I -v�-Z <br />