Laserfiche WebLink
EL�CTRICAL P��IVilfi i4PPIL�CAi�01� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everetiwa.org 7� O g� � S <br />�,so�--ou2 <br />�G/a Tay �v�- c�l_V�ve <br />PROJECT ADDRESS <br />Sct �1 a�-c� <br />owner <br />(.lfl'���� <br />tdad �ddress <br />Tenanl <br />%,�,al'er �e���c <br />Mail Address <br />�y�3 <br />EleclricalCoNrado� MailAddress <br />���jLL1L�'�`��%l�5 <br />Stale License Number (required) <br />�✓eu�� <br />City <br />c�N <br />� � �� 5 � �(.1= �d <br />Proposed i:se of Building <br />�o�d sc,�. r=�• <br />Square Foolage Qf residential new conslruction, remodel or addi',ion) <br />Numher of devices (If low vol�aye) <br />City <br />� /� / <br />Description of Work to �c Done: /�=^ e O� �°� <br />-�_ �Z t1cS � !'� � L f �.-- /2P t� �-l.T I 1� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Slale/Zip <br />SlatclZip <br />sJ't �le LsSA ' <br />StatelLp <br />Phone <br />�NLS� <br />'�� �1��.� S�/ S <br />Pnone <br />636qy2 <br />City ot Everett Business License Number (required) <br />Sk <br />CoMract Pricc of Work <br />Contact Person/Contact NumbedEmail <br />�vt� � - l �l'�� � ---- <br />1 hr.reby ceAify fhat 1 have read and exarninr.J (his aPP�icafion and I<now (he smne lo be lrue mid <br />r.orrecl. All piovisions ollavu. anJ ordinances goveming this fypc o! wo�k wdl he r.ornplcled <br />whcU�er specrlied hr,rr.in ornnt The gianling ol o perrnd dnas not P��'�����»e fo g�vc auUiority fo <br />viola(c or cancel Ihc p�ovisions o) ony o(hur sfafc or local law rr.gul;iling corrslrur.Lon or ihc <br />pr.r(onnanr.e o! consf�uclron. Thal ! am �iufhorized by Ihe oivncr o/ Ihis properly to pcdonn fhe <br />�vod� lor �vhich apGGcalion is made and 1 comply ��i(h fhe Sfafe Confrar.fors Law 7A.27 RCW and <br />2762��dC-- _— <br />�-C� ^ �� d ��(�8-�20/ $ <br />� � <br />� �--��$u-pY�_W� —�_�__—_-- D Ic _—.__ — <br />rN.-vCS O on/JrrorJ <br />F[L -- ----� <br />--� �[�. °� <br />PFRMITtI <br />E I�d1-by2 <br />:2 <br />