Laserfiche WebLink
� <br />_ I2e5� �-v✓�-+ �L <br />� <br />ELECTR9CAL PERMiT pPPLVCAiI(�i� <br />PROJECTADDRESS <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, GVERETT, VVA 98201 <br />425-257-8810 - FAX 425-257-8857 - wrvvw everettwa.org <br />� <br />vJ I I o�.� °I.�� <br />�o (S r�'Yjc� <br />owner <br />Tenant <br />b�Z� <br />I�ia�l ACdress <br />t.^3�I ACdress <br />C �i� C <br />hta�l ndtlress <br />�,'� t.U�-3 L r1s �i�i� <br />Slale L�censa �Vumbe� <br />SFR <br />,J.II�,r� �r� <br />— c�iy <br />CJy <br />I1�'�'' Pl S�- <br />C�ty <br />Proposed Use of �uild�ng <br />/ <br />l� <br />Square Foolage (If residential ne�v consiruclion, remodel or addilion) <br />/% <br />! <br />Nurnber of devices (Il low voltage) <br />��ere� LJ�- <br />f7escnption of VVork to Be Done: _ I��i�i\c�(r _ d� Z�I�J <br />_.,�r�]�^,1�1� ��� — (r.Y�l�— t�.c-�1"�) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />State/Z�p <br />6 -da—�r� <br />� �u�6��� <br />�, ZS <br />�3 35�3 -z� <br />Phone <br />State/Z�p ULS. Phone <br />l!'�' �U�v �� � <br />Slate/2.p Phone <br />� L� <br />CoNracl Price ol UJoik <br />Contact Persnn �Plan Review) <br />L� .� c�, � � iu/' <br />I l�ereby cedJy Ihaf 1 have read and e.ramined this application and hnovi pie same fo be fiue and <br />conecL AO prov�sions olla�vs and ordinances goveming fhis type ol �vork rrill be completed <br />whclher specilied herem ornoL � he gran�ing ol a permif does nul presume to givc au(horily lo <br />violate orcancel (l�e provisions olany o!heisfale orfocalla•,vregulafinq consfruclion orthe <br />pedoimance o/consfrvction. Tliaf I arn auRionzed Ly fhe o�vner o! Ih�s propeRy �o peAorm fhe <br />��✓ork lor �vhich applicafion is maJe and 1 comply wifh the Sfale Confracfors Law 18.27 RC4V and <br />Z96.200 WAC. <br />,� (/ �/ '/'� ,W� % (� Jr'� � � it <br />��4r•• <br />FEE <br />J�� <br />PFRh1CT� 1 <br />EI�fO�� 00� � <br />