Laserfiche WebLink
S1/21/2011 15�43 FAX 2069326536 <br />� oo2ioos <br />ELECTRICAL PERIVIIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 �`ll <br />425-257-8810 - FAX425-257-P857—www.everettwa.org j� �'D� <br />APPLICATIONS ARE AGCEPTED FROM 8 AM TO 4 PM �/ � II `' �" <br />/ 3/ID /97`' ,� SF <br />PROJECT ADDRESS <br />OW118f <br />Tennnt <br />f l� 19'� <br />Mall Atldrr.ss <br />tdcril Address <br />C+ 2� let�rz. d.•� 9 � 9 st,� �s�+� <br />EledrlcalConUactor Ma��Address <br />CR����z � yis aW <br />Slate License Number � <br />pI..�M� �,. �t ry�,.��. <br />Proposed Us of Building <br />�escription o! Woiic l0 6a Done: <br />ciy <br />ciry <br />Slate2ip <br />S�s�e21p <br />Stale�Zlp <br />�73 °� <br />ConVect Pric.: of Work <br />`%Od���f�4i.w� <br />ConWct Person (Plan Review) <br />�CL i G �P C�Glaf4 �-C.� �'EEt� IYr� <br />NOTE: WIRING IN NON-DV�lELIINGS IS REQUIRED TO FEE <br />�E IN RACEWl�YS, �dC OR AC CABLE. <br />�a.a.6g <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereLy certify that 1 h,avo rend end examinod this applrcation and know fho samo to be true and <br />correct. AI! provlslons o�laws and ordinances govemmg thrs typa o( wak will be completed <br />whether speciTed herein or not. Tne 9ranfing oI a pemvt does nof yresume M give du�honfy to <br />violafo or cnncel the provisions ol any other state urlocal law reguleting consfruchon or fhe <br />peAormance olconsiiuctlon. That I am aufhonzed by the owner o(fhis property lo pedo�m tha <br />wonc Ior wRich applicafion is nrade nnd 1 compty with fhe Stafe Contracfors Law 18.27 RCW and <br />296.200 WAC. <br />_ „�,� <br />F'hane <br />PhonO <br />�Z <br />Phone <br />CIl l i - I�-� <br />