Laserfiche WebLink
ELECTRICIo►L PERMIT APPL.ICAT�ON <br />CITY O� EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-H857 —www.everettwa.org <br />APPLICATIONS AiiE ACCEPTED FROM 8 AM TO 4 PM <br />�- s� �PI v�l Ev��-�-ii �.J�1 <br />PROJECT ADDRHSS <br />Ownef <br />Tenant <br />Mail Address <br />Mail Add�055 <br />�. �I�e�,i�rlr, P� P�c <br />ConVactor Mail AddfBSs <br />S-1 <br />r1M��D��ao�D4- � <br />State License Number <br />Proposed Use of Building <br />Descriptian of Work to Be Done: <br />Ciry <br />City <br />City <br />NOTE: BERN �CEWAYS MEC R AC CABLEUIRED 70 <br />CITY OF EVERETT �OCAL SALES TAX COOE IS 3105 <br />1 hereby certily that I have resd and examined fhis app�ication and knOw <br />correat Allep�roed�h re � o�rnot �76e g�ranGng �a P m�iit d�osesrynot�rese <br />whethersp p <br />pe�o�ancenof consiruction nThaf � am�auth�naed by the'owne9o(fhls�� <br />wmk fo�wh�ch appllcation 1s made and I co�p�Y wifh the State Confracfi <br />SfatrlLiP <br />State2ip <br />State/Zip <br />Plwna <br />Phone <br />"s3•f��41�� <br />pnone <br />� �7��•�� <br />Contract Price: o! Work <br />�h�A.� -�C � I� - <br />C no ��1�(P�^ Review) <br />FEE � <br />_�5� <br />�mP �� � G- I7 � S O 1� <br />i aufhOritv fo <br />