Laserfiche WebLink
�- --- --- — ------ <br /> ELECTRICAL PERMeT ARPLICATION <br /> ' CITY OF EVERETT PERMIT SERVICES I <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> I 425-257-8810 - FAX 425-257-8657 -www.everettwa.org <br /> I <br /> 02 /-i � s�- F, ( �u . <br /> PROJECT ADDRESS <br /> I <br /> ' �� �, ., � ���. � , s ozzq 1� I v ���� 1A `. 9rr7o4 —.�`�r7 <br /> O mef Mail Address CitY State/Zip Phone <br /> , U�w�� <br /> 4zs � zGs � v5�; <br /> Tenanf Mail Address City StatelZip Phone <br /> � � ���c �r, ( <br /> State/Zip Phone <br /> Eleclrical Contractor lda�l Address City <br /> Slate License Number Contract Price oi Work <br /> Proposed Use of 6uilding Contact Person (Pian Review) <br /> Square Foolage QF msiJential new consiruction, remodel or addilion) <br /> � Number of devices(If low vol�age) <br /> I � '. G� i�L�NHiL IL���� <br /> Desc�iplion of Work to�e Done: ��+���� —r �� —} '� "�� - <br /> � <br /> I <br /> i FEE � <br /> � � <br /> II CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �' � <br /> ' I hereby ceRily fhat I have reao and eeamined lhis application and know the sarne fo be tiue and <br /> �i conEct All provisions o(faws and ordinances goveming this type o/wo�k will be completed <br /> �. �vhetherspeci(ed he�ein or noL The granfi:tg o(a pemiif:'oes not pmsume fo give au(honty lo PERMIT# <br /> �' violate orcaricel fho provisions o(any ofhersfafe orlocalla�v�egtdafing cons(rucfion or fhe r '3 O }_ I��-� , <br /> �i perfom�ance ol conslniction. That 1 am authorized by Ihe ownerolthis propedy lo pedonn Ihe <br /> l <br /> � �,voik lor which applicalion is made and I comply with the Stnte Contracrors La�v 18.27 RCIh�and <br /> 296200 WAC. <br /> �/,�(�/C��CJ� ) <br /> �� SignaWm Date <br /> i <br /> I. , �, ._,.• . . � <br /> �..��_.u �...,-�� <br />