Laserfiche WebLink
--- � • -� <br /> ELE:CTRICAL PER14�lT APPLICATIO�J <br /> CITY C�F EVERETT PEi2MIT SERVICES <br /> 3200 CEDAR STREFT, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857 — wniw.everettwa.org � ,,,�Z --/S— <br /> �/�0/-C�� <br /> � � �� /�.1`�� � � � t_t_)� . <br /> PROJECTADDRESS �,r� �t �� CpQ '��'� <br /> �_ ({�J�S <br /> �C'��C, �,�� Pk�� ��,�<=� W�� � �� �3� <br /> Owner MailAddress CAy SlatelZip Phone <br /> �e �5 ��pJ� _ <br /> Tenant Ma�l Address Ciry S�ate/Zip Phone <br /> �sa� vas <br /> �� ,,�� ��-�,� ����,�P �. �.�������,�� ��7 ��.���z� <br /> Electrical Contfador Mail Address C�y Slate/Zip Phone <br /> S�c��l�'��C� ��� �� <br /> S�ate License Number(required) City of Everett Business License Numher(required) <br /> Proposed Use��d ng Contract�W rk <br /> �'C�y� �a � � �` <br /> Square Foolage Qf resideNial new consiruciion, remodel or adddwn) Conlacl Person/Cont cl umbedEmail <br /> j�(��,5'�����c��,� �c,� <br /> Number ot devices(If low vollage) <br /> Description of Work �o Be Dane: !7G'� � ��LV9l�C5—t" �1.i7-/� �✓�� � /'�Q �-F� � <br /> �-i� " �v �t� i.JP K' c Lo.� ' � <br /> ,t�Q�'�.�-,--..--r✓ ' �-'�— <br /> FE[ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �� � � <br /> I hc�eby certily lhal I have read and examined this applica(ion and kno�v the same to be We and <br /> cormct. All provisions o/laws and ordinances goveming this fype ol�vork�vill be completed <br /> �5-hether specified herein ornoL The g�anting ol a pe�nif does not presume to give authonly fo pERMIT# <br /> violafe or cancel fhe provisions o/any ofher sfate or local law regulating consf�uc(ion or the E �5 b � - b 5 �f <br /> performance o/constniclion. That 1 am au(honzed by fhe o�vner ol fhis property fo perlorm fhe <br /> wodr Ior which application is made an 1 iply wifh fhe Stale Conlrac(ors La�v 18 27 RCW and <br /> 296.200 W C. <br /> ro� <br /> ignature Date <br /> r <br /> REVISEDOP'05^.O�a <br />