Laserfiche WebLink
II-23-2009 08:51an From-tiRGNSOi� SECURITY GROUP +p06 285 6E97 <br /> T-295 P.002/002 F-131 <br /> i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT P�RMIT SERVICES <br /> 3200 CEDAR STREET, EV[RETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—�w✓�n�.eyerethva.org <br /> � // � � 3 � . <br /> APPLI�ATIONS ARE ACC�P7ED FROM 8 AM TO 4 PM �D 9���)(� <br /> � ' ' <br /> � 2$�� ESo'tt�1��� �v�(�tr hF1C,-�;Ula� • - <br /> PROJECT ADDRESS <br /> �t'�o�i -n�c� �� �'osc 3�4 � — Q _ <br /> �� r,�ir � 6 3 S 9rx�+ {� <br /> Owner ��� � ' ` ` " � �" <br /> Fdail Atldre55 � � � City . State2ip Fhone <br /> f'I?�v�D rv�E- m��� C2eEr���m Pu � �°�J�5 <br /> Tenant , 61aitAddress Clt; � <br /> , St,te21p Phone <br /> I12oi.ix�u�Ec�P_�Ty Gt�ua C x7.�V/ <br /> Electrical Cuntractor `��7 �"A`R� �'U/� ���04 �u�, �y 35J3 , <br /> Mad Addre..s � City� .` � State/Zip Phonc� <br /> ,� 15 OS �J,vS �� n <br /> �1�Dlv�C__C'��3C ln ���v `�5�2 � <br /> State,�cense Wumber <br /> Con�ract Price of Work <br /> Proposod Usr ot 6ui:d�nq • Conlnct Person (Nlan Re�icw) <br /> Descripllon of Work to Be Done: _(.K.'S7t1�L.()(�� U OC-TAC E SECv�2i TY S y S�ryl �� ��ys� <br /> \ . <br /> NO7G: WIRING IN NQN-DWELLINGS IS REQUIRED TO FEE <br /> !3E IN RACEV��AYS, h1C OR AC CABLE. <br /> CI7Y OF EV[RE7T I.00AL SALES TAX CODE IS 3105 <br /> !hereby certi(y tnat l hav�read�nd exarnined(his appqcafion and I<now the samo to be true and 1� (J"� � I ' ��� <br /> co�iect. A!�proi�ision:;of lBtvS.altd ordin�ncAS govemrng ihis rype o/tvork�.+�ili be completed <br /> whetherspecifiedhereinornoL The,rranlGigofaperm�Ido�snM resumetoyiveauthontyto <br /> viola(e or cancel tf�e provisions of anv other sfate or/eca!la���reguPting construction or 1he <br /> pes(omiance ol ccnstruction. Thst l am autho�zed by the o�rner ot th/s property fo perform ti�a <br /> �vor;;for�vhich spp!lcatien is mode�nd I com J wifh tiie State Cont;ec ors La�i 18.27 RCIV and <br /> �29'�OD WAC. �Y ` <br /> �'v"------- I L- 2�3 - p <br /> Sipnalure ea� � ` _ <br /> f �_ <br />