Laserfiche WebLink
d4/16/2D15 16:24 2532882156 GAP.NEP. ELECTP.IC PAGE O1/04 <br />EL�CiRICAL� PERMI7 APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3290 CEDAR STRCET, EiVERETT, WA 98201 � <br />425-257-8910 • FAX 425-257-8�5?—�w'nv.everettwa.org � �`�..�� <br />I I l D2 )��' ]�r. �� <br />PROJECT ADDRESS <br />Ov:n2r <br />Tenznt <br />�A311 Adtlre;6 <br />1.58;1 ,addless <br />Ciry <br />C�tv <br />C /�UC(� IOL <br />5!atelZip <br />5:3�B/i'�p <br />Phone <br />Phone <br />� C cLrne.r 1'-6as.�22`-�5 �-2"-� Auc �� �� l� A q� 2J�-�92-(�USi <br />i EI2C1GG3i COO,f2Gi0.' �•1BII Aidres? Crty SiateRlD Phore <br />C��-rLv��ws�K� <br />Slate Li�anse Mumbsr (requiro�) <br />ProD�s°U Us2 nf E�'Jdinp <br />Scuaro Fcotagn (If resldentia! new conSxucC�cn, remo6el or addlHen) <br />tdumber cf dcvices (If lo�v voltage) <br />pr;cnp,ion cf Wcrk to Be Done� <br />CITY OF EVER[TT LOCAL SAL'cS TAX CODC- IS 3'105 <br />�j�9og <br />C'ry of Everact Business Liccr,se Numb2r (r�qWretl) <br />�� <br />Conttacl Price et V���rk <br />�i f I C�. -2n.�-�.le._31�U��3 <br />Ccn:act'er;onlContact Numher/Ema�l <br />1 heraby certrly �nat I have rnad and cremined ti�is applica0on and kno�v fhe s2ms ro be frue ond <br />correcL All provlsinns ot laws end ordinances goveming Ibis tyae o/ work will Ae completod <br />��ihcfher specdied hernin a raL 7he granfin9 oI a po�mit doas not presumo 'o qiv� oufhorlty fo <br />viola!e cr canr,el flro provisions of any olhe� stele orlecal law regula!Ing consWcticn or thc <br />per`ormence el consfruclion. Thaf I am aufl�onzcd by th� ownor o/;his properfy to peAomt the <br />�:�ak la u�nich applicat�on Is madc �nd I corr,ply �vith the Sfate Cornractors Law �827 FCW �nd <br />296 200 bVAC. <br />k: NSED CGC✓t0;rt <br />FEE <br />� 5b.°° <br />PER� 1ITr <br />E I�oy � I o0 <br />