Laserfiche WebLink
`4 � I S <br />PROJECT ADDRESS <br />T�IS��I <br />Owner <br />Tenanl <br />❑ <br />� <br />ELECTRICAL PERMIT APPLICATION <br />GITY 9F �V�RETT PERMIT SERVICES <br />3200 CEDAR STREET, EV[RETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - wanv.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />u��F � <br />s�livN <br />P.1ail Add�ess <br />�d�il ildtlre55 <br />()u9 H6� � I 5 }��,,� 'l��w,�,w�s U7�1- NooN <br />���3 <br />C�ty <br />Gty <br />State/Z�p <br />StatMTip <br />�e�a�y�3 <br />���3�0 -► s� <br />�`I►-/���0 ���5 5�«5� ��Vtc� I�, 3L� ku�,�.h J��� — <br />Eleclrical CoNrac�o� lvtad Address CAy Slatc2ip <br />�i�� �YG.ltN5514'�.�� <br />Stale License Num6er <br />��s �� �,c� <br />Proposed Use of 13uildinc� <br />Squaie Foolage Qf resideNial new conslructicn, remodel or addition) <br />Descuplion ol Work �o He Done� __ <br />Conlracl Piice of Work <br />Conlac� Person (Plan Revicw) <br />—�✓`��ca, `=ot� _ /a5t �sAnD _ Nk�A`c�— <br />NO fE WIRING W NON-DWELLINGS IS REQUIRFD TO F[E <br />[3f_ IN R�CEWAYS, MC OR AC CA�1.1= . �o <br />,�b � <br />CITY OF EVf_RETT LOCAL SAL[S TAX CODE IS 9105 � —---- <br />1 hmeby r.criily fhof I havc read and exnrnined fhis opplica(ion and kno�v the sanm to hc huc and <br />r.onar,l All provisons oll'utvs !md ordinanc�ts r�ovcrnniq Ihis fype o1 �vnrk �:-rll bc r.ornpleted <br />i��befha� spr.rnlied hrm.in orv¢i(. Thr, �ranhng ri/ �i pr.rmd docs nof pm�vme [0 9ivn iulhonty to <br />viola(o or c:�ncel fhe provisinns o/ any olhr.r stalr. or local law requloluiy conshur,fion or fhe <br />peAomiance olconshur.Gon_ Thof I am authon�ed hy fhe o�vnr.i of (hi: piopr.iry to pe�lnmi Ihe <br />�t�orl< for �rhich applicalion rs rnade and I r,ornply �:a(h fhr, Sla(e Contrar,lors La�v 78 271dCW and <br />23G200 WAC. <br />— �i`-<"' ���i✓fsGr1_ —��� _hI J.J'�.�� <br />ISignalure — - fiale <br />Phooc <br />Phone <br />Pnonc <br />El�iO- 152 <br />