Laserfiche WebLink
�un 20 OB 09:59a p.l <br />' I <br />ELECT CAL PERMIT APF�LICATION <br />CITY20 E�VER ETT PERM�IrT`SER oICES 6`aa_o� � <br />A25-257-8 0- FAX 425-257-8857 — www;leve ttwa.org �0 �0 {�' j0 � <br />APPUC IONS ARE ACCEPTED FROM 8 AM T 4 PM <br />� <br />� /�f/l/� /tr t��.i <br />PROJECTADDRESS �' ' 3 �� <br />� <br />.��g < �r a � ,�v � � Yo <br />Ovn10f Moll Addr Clty �� StaN21p Phone <br />i i <br />I <br />Tenant � Moll Addr Clry �. S1n�s2ip �hone <br />, y� <br />�'�-h�lJk%r�ti sr.�S � o ' 1.e/ a r <br />EIgC�ical Contractor M1tali Aaare Cib j �, State2ip . Phone <br />� <br />State License Numbor � �.0 nVpct Pdca of Wcrk <br />i <br />Proposod Uso of 8uildiny �I i,, �C ntaCt Person (Plan Revlow) <br />Descrlptlon of Work to Bo Dona; O � C � � <br />I <br />y � I <br />ON ` I � <br />� I . <br />I . <br />NOTE: WIRINGINNON-DW[LLINGSI REQUIR6DT0 FEE <br />eE IN RACEWAYS, h1C OR AC BL[. j ! �< <br />�O ' , <br />CITY OF EVERE7T LOCAL SALES 7AX CO IS 3105 ' <br />� herebyCeRIN thet /Oavo r9ed end exemine Is eppllcoLon end knowfho sem9 to 6e fNo and <br />:orrncL A71 provlslons o/ls�vs and olClnonco o��oming thls fypa ol work will bo ccmp/ofad� <br />ronethor spod0ed herom or nof. 1T+e prontln f e pormR tloes notp resume to �/vn eu',hon fo <br />✓lolate or cencel fhe provis/ons 01 ony o(hors ,e orlOcal fBw ropul9lMp Consf�ucGOn or fha . �� <br />7erlormence of constn�cflon. 7hat 1 om out� .etl Ay 7he awner o/ ihls propeY,y fo perform t e <br />vork forwhleh appllcatlon Is mede an01 cem � wfth the Ste}e Contraefofs Lew 78.27 RCW nd <br />29S.2U0 l:'AC. � <br />� .�.i �� � � . �l <br />pnawre . . °� . �� _ � V � <br />i <br />�� <br />v <br />