Laserfiche WebLink
� ='3'./2i�15 GS.:' i5D;7;0125 C:.��...ELSC:1 =�__-P.i= _,�_ ei;d5 ?.GD1 i :01 <br /> � ELECT�?iCAL PERMIT APPLiCATION <br /> � CITY OF EVERETT PERMIT S�RVICES <br /> I <br /> � 32C0 CEDAR STRcET, EVERETT ; VJA 98201 I <br /> : 425-2.57-3910 - F�U( 425-257-E857 —www.everettwa.gov � <br /> i � <br /> , I <br /> � � � <br /> �! ,kt � �}U� <br /> PROJECT ADDRESS <br /> I 1 <br /> '� �r���?��^Ql_KUi C!ff1IG ��e�,Y (itic4�'Z/_9 `��`''SoS-Z!•46 � <br /> i O�mer Maa Adtlress C�y S�a;e.Zp Phonc <br /> I <br /> ( <br /> I � <br /> � TCnant t.totl Atldress CIIy StatrlL, f'honc <br /> I <br /> I <br /> _' n ,l. �ti ����r�_L,�n�o�y��v'�tr_,sy�v u�r3- 9�izz yZ'�359-�e�rlY <br /> � flectncal:;onlractcr r.sai�namess r_iy sca;rn;p Pho:ie <br /> � <br /> � ' ���{ �' SZ� �. Q3t 0�1 � <br /> IStaie License Number irequired) City of EvereK Business License NumCer pequi:ed) � <br /> I <br /> � �SCY�.�a i <br /> Proposed Use e`du.ldirn� C^r.tract P:Irr of Work <br /> i <br /> c� I <br /> � – ��n �l�wi�lro . � 2� ,j-iT ��-- <br /> Souare Footage Qf res�denuai new censVuc:icn, ;emotlel or adtlition) Concacf Pers�mCent Numtx;rlErt�ail I <br /> I �;�mber otCev�ces lit lowvollage) <br /> I <br /> r /c T � <br /> Descrip;ior,of Work to Be Uone� _ �,;�(1�.. U'UJ d.�, � (,�ti,' ) _ � <br /> � <br /> i <br /> � — <br /> I _ I <br /> - -- — i <br /> � � <br /> ; I YC� I <br /> � CITY OF EVERE77 LOCAL SALCS TAX CO�E IS J105 .(1., � i <br /> ._� �� � , <br /> I h:�eby cc�U,'y!ha:!have read anJ rxaminrd lhis apF���afion anC laio�v th�same to be bue and ' i <br /> co�c( All provrsions o/li�vs dnd c•Oinaece::qov�rmrg thi5 rype o7�scr,-u�U1 be�omp/etr.d �— <br /> whr7lrei specdreAhrnrin orno[ The grant�rg of r�r,errnAdr�s not p�esume fo nive auth�nty:o pEl -Rh��;r � I <br /> wolate o�concef!o•�pruvisions v/anyo;he,s!a(e u�:ocalla�vmqulaLnoce.^,str�chb.�or:he � � ��D/�/DD� <br /> iprr/omi or.e oI c,:�st+vciior That I am au.i;or7rC Ay the o::nn�ol this pr�per�j�o peAom�tlic �I <br /> work lor which a;.p,r,.:tion�s madr ar,d I comp.'/�vith th,e Sfalc Cont�attcrs La•:� iR�'RCNa^d I I <br /> � 296.2DJ LYAC. I <br /> � <br /> � -��f�`�_ 1�l✓�- _ � <br /> I « on�c � <br /> II <br /> � F;vi.S`OcSCAaT< I <br /> - _ - _ _ __��� I <br />