Laserfiche WebLink
Api 09 150126p <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-86t0 - FAX 425257-8857 - wvwv.everettwa.o�g <br />o(�i� -1�'aU�or' ���z <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />JcUYcal Coohactor <br />2a� i 7biu �,- s�a � <br />Ala'1 ACdrec� <br />MadAOdmss <br />�� <br />Mad Addmss <br />1�0� ,F T � i�mDo <br />Stato License Vumbcr (reGuim <br />� LT S�r✓ <br />?roposed Use of Buildng <br />Scuare Footage (I'resitler5al newconstruc5on, remodel ar addrtion) <br />CSy <br />cn� <br />CIy <br />StaldZfp <br />S�tcflJp <br />Siac�p <br />p.i <br />Ptro�e <br />Phonc <br />Phone <br />_ ��--5 I � � <br />C:,y of Evered Buvness License Number (required) <br />� ��, <br />ConVaU Price of Work <br />Conlac; PcrsonlContact NumbcrlEmail <br />Yumber of devices (If lor� vollage) <br />Descrlptior� of 1h'ork to Be Oone� ��(��j � f V�1 �� 4�'`� ���� �� � ���� {'� �' � I n <br />\ . . <br />CITY OF EVERETf LOCAL SAL[S 7AX CODElS 7105 <br />1 hen:by certrtyfAaf 1 have read ond exomineri this applica(rvn and know Ihe some fo be true and <br />cormct. A!I pravisions cf Jmvs and adinences govemmg fttrs fype o! �wik will be complefed <br />wbether speciAed Ireiein or noL 7T;e granLng o/ o permif dces oot presume to grve oufhonry to <br />viclafe or canco! tho provisions o/ any olhur slala or Iecaf la�v myufating conlln.•cfion w fhe <br />pe�fomience ot consY,vct�on. Tha11 em autholized Dy tho owner oi thi: pmperty fo peAom. :he <br />work lor u�hiah applicatlon is made anA f co�myi� �•i1h fhe Stefe Conlradors Lniv 78.27 RCW and <br />295200 4VqC. _ / / ���-�� <br />��� <br />Rcv:s_D oRoeC: r. <br />FEE <br />�'(5 D� <br />PERMITC <br />E 156�- 0 <br />I <br />� <br />� <br />