Laserfiche WebLink
ELECTRICAL PERMiT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 (,.� �.g_�(� <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org � <br /> E/yo U--o � <br /> � Cv00 /`��v'ri �� Cree�< Pc, r�w� 0 <br /> PROJECT ADDRESS <br /> /cl G S oZ a`'�-l'� tr-c_�L�J <br /> , ��� ., , L� o� L � s r,:, w �9 gt3i� e <br /> Owner t.1atl Address City StalelZlp �}{— Phone <br /> ,�/ /� .�V'e rr—�--��1 <br /> �'e-�9vi -e- ��/� (� � /e.-v.���L �ec� �,F�. ��- olD6- �1l6- / 7� <br /> TenaN tdad ACtlress City �ate2�p Pnone <br /> L �� wo`� vzs - 7y3 <br /> S ;�.�Pe.,� `'c le � . �S�a� � 3S'� /4�„e. l,U. y c�J/-� 9B��g �o <br /> EleCtrical ConUac�or ld;il Address Gry StatelZip F hone <br /> � <br /> .s �Na ���9�oQ3 _l S�� � <br /> Stale License Number Conlrad rice of Work <br /> I GiJr� �P � o��-�- �Lie � 20 � -�3a- <br /> Proposed Use of Building Contact Person (Plan Review) d I <br /> � <br /> iSquare Footage (If residential new construclion, remodel or addilion) <br /> � <br /> INumber of devices Q(low vollage) � <br /> Description of Work to Be Done C� �"L.tiv�S f � ��° /�wt vL � ( j��e I <br /> �{'� X �`ti � �s �-� �� s � T-S �'�� u ��- t �� <br /> , <br /> �,x �� �-� � — <br /> FCE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here6y certily thal I have mad and erarnined Ihis applicatron and hno�v the sarne to 6e true and �� �O <br /> correcf. All provisions of laws and ordinances goveming this type ol work will Ue complefed <br /> �vhe(herspecified hemin ornoL The granting oI a pertnit does nof presmne to give aufhority�o PERDIIT# <br /> violale or cancel the provisions of any ofher sfa(e or local law regulating consfnicfion or the � ' / <br /> pedorrnance o/conslruction. Thaf 1 am aufhonzed by fhe ownerol fhis propeRy fo perlo�m!he ' � O y _ O f�� <br /> I �vodc lor�vhich app6cahon is madc and I wrnply with fhe Sfafc Contracfors La�v 18.27 RCW and � �� <br /> 296200 Wi1C. , � , <br /> ,i-�- �` g-� / <br /> Siyna�ure Date <br /> izsvise�v�vi� <br />