Laserfiche WebLink
02/:2/2�15 09:35 2532BN2156 GARNER ELECTRIC PAG[ �3/04 <br />EL.ECTRtCAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERLT-I, WA 98201 � <br />425257-8a10 - FAX 425257-8857 – vnvw.evereM��a.org � — I % — �5 <br />! 12[`� I q�-h >+-. 5� <br />PROJECT ADDRESS <br />Cwner <br />Tenam <br />!dail P.tldress <br />61fi�� ACC�f45 <br />Clly <br />Clty <br />C=1�6a �°GI 2 <br />siaierzio <br />SlntelLip <br />Phone <br />�'hOnC+ <br />C'-� rrner �lectilri _ IA- 2�/2S ,�2 `'�`',4�e S!(A,n-1- I.JA- �ZS'��z 51 <br />Elec,rical Contractor �dau.aCtlres; City S�n�e2�p Phone <br />� Y� �OT (�L) <br />State License Num6er (required) <br />Proposed Use o` Building <br />Squere Footaye (If resitlenBol new constructioq ramotlel or addiNon) <br />NumDer of devices (I( low witage) <br />Descdptlon o! W�ik to Be Dane. <br />CITY OF FVERETT LOCAL SALES TAX CODE IS �105 <br />Q5z�o9 <br />Clty of Everett �uslness License Number (requiretl) <br />`� ��j � <br />Contr�ct Pnce of Work <br />i 1 I C �4-e.1P ��� - r� -2�3 <br />Contact Person/Contact Number/Email <br />I hervby curtlly thot I have rend end exam/ned f01s epplica(ion antl know tAo samv fo Oe frve and <br />corrpcL ql! provisions of laws and o�din�nces govr�ming fhls type o/ work wlll be completed <br />whe�her specified herein ornof. A�o granting of a permlt does not presume fo yi�u au!honty to <br />vio/ato or cancM the provisions of eny oNer stefe or local /a�v rrpulnnny consfruction or fhe <br />pertormnnce o( consbuctwn. Thaf ! am authonzed Uy fhe owner ol fnls property ro poAorm (he <br />�vork lor whlch applicofion is made and I comply wrth the Sfafc Contractors taw 1 B.27 RCW end <br />7.96.200 WAC. <br />RFYISED pC06'Of1 <br />�E 5�v" I <br />PERMITu <br />E 1502- 0�2 <br />