Laserfiche WebLink
ELECTINCAL PERMIT APPWATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-B810 - FAX 425-257-8857 — www everettwa crg <br />I oz136 Avc <br />C luz3-v6/ <br />PROJECT ADDRESS <br />4 4� Ekes 771 JA � _ 10430 ��.�w�r� alf-dr'Y f-6 <br />Owner Mail Address City Slald21p Phone <br />Tenant <br />Mail Address <br />City <br />Stale/Zip Phone <br />RoWj OWhf <br />Electrical Contractor <br />Mail Address <br />Cry <br />State/Zip Phone <br />State License Number <br />Contract Pnoe of Work <br />Proposed Use of Budding <br />Contact Person (Plan Review) <br />lg1(0 <br />Square Foote a (If residential new construction, remodel or addition) <br />Numbor of devices (If low voltage) <br />� <br />� f <br />�aC K(1 <br />Descnpbon of Work to Be Done <br />�J <br />�ke 'tC/ <br />�r/ <br />t I� tq a, M14e �4`7tSj <br />) 1 <br />LICS/ bN4»/ e 6 fu>, <br />lit / I'll rouLI� <br />Oyt-t ek4J,1'c <br />OtJi0 acids ` f0 <br />YWL !%LSt7-T (110v) t 0he dq/nt <br />FEE <br />^ I <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 T� (• l <br />I homby certify that 1 have road and examined this application and know the same to be Imo and <br />coned. Allprovisions of h:.vs and ordinances governing this type of work will be completed ---- <br />whether specified herein or not. The granting of a permit does not presume to give authority to PERMTTtt <br />violate or cancel the provisions of any other state or local law nagulating construction or the <br />performancoof constnrdion. That I am authorized by the owner of this property to pedorm the E I (rl U _ O 4�) <br />work for which application is made and I comply with the State Contractors Law 18 27 RCW and <br />296. 200 WAC. <br />Rf'VIS PY t3 <br />