Laserfiche WebLink
� ! <br /> �LECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8357—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 1 D 333 - 19�" 1�,E. S.E. � s-re. �b� <br /> PROJECTADDRESS <br /> SLJ Ass�gL�S ,LI� -l�3?A -1387N Pur� Sour►�we6T, 6�'�oNDs, WA 98.�2b <br /> Owner Mail Atldress City Slale2ip Phone <br /> MopERN i�� �b^,533 -19T"AvB. ��� S?L' l01 �E,v6�, WA. `182A1 <br /> Tenant Mail Adtlress City State2ip Phone <br /> 11��i+ 1�oR.-ruw�s� -12t -O�. 9�'*� Sr. , S�.a�r�.�wa. 98toi (?�lv� t�23 -31C� <br /> Electrical Con�ractor Mail Address City State/Zip Phone <br /> �{F,A"iif nt�961�Z. ��Db.°O <br /> State License Number Contract Price of Work <br /> la�c-�a.�_ ��u.� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to ee Done: �NS'[',41�,.A—t�G1�i oF �1> �jEW 1NTERN P.LL.`{ �L1..0 A-11NAT&� <br /> SET �F l�l�� _G4 ANNEt- LP.i i E'�S �- � C►�ANNE(. yVr�2� &�X ' � <br /> R� " Mop61t,N 1n�1AaE. ��N" . <br /> NOTE: INIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC��R AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS:1105 <br />' I heieby certily that!have read and examinea this application and know the same to be true and <br /> conect All provisions olla�vs and ordin2ncas governing this type o!work wil!be completed <br /> whether specified heiain or not. The granting of a permd doos notpresume to give authority to <br /> v;olafe or cancel the prrn•isions of any other state or local law regulating construction orthe <br /> parformance of construction. That I am authonzed by(he owner of this property to perlorm fhe <br /> work/or which application is made and I comply wi(h fhe State Contrectors Law 18.27 RCW and <br /> 2P6.200 WAC. <br /> �/W WI'� <br /> SignaWre Date <br /> v /�/ /lY" J <br /> � � o _, �x C <br />