Laserfiche WebLink
ua � i.>; zuo� i a::�a r•n� <br />ELECTRIGA,L PERlVIIT APPLICATION <br />C�TY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICA'fIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />5-�04� �Ia`r' �r v`/ (Glenwooa.Cres� l.�oT �o� <br />PROJE�T ADDRESS <br />� aotiooi <br />t_c. �o�-u�t-,o� -PM� u��,v�s�Y�•�A,:�, E.,�-�,wA,��zo� yas 2�13 S8s'2. <br />Owner Mail Address City StaleJZip Phone <br />Tenant <br />Mai� PdAress <br />City <br />s�a��zi� <br />Phonc <br />vQxflc�� E1e��-r�c.�11v 5-��4 `-ls'^�A�NE� LiLSie�nt VJQ•�I$?�$ �k2�3'�611,00 <br />Eloclricpl ConlraCtof Mall Address Gty Slale/Zip Phone <br />v F!-2.laEEL�I"li3Y�A(7 <br />State Licenso Number <br />Proposed Uso of Duilding <br />Duscription of Worl: to Bc Qone: �� Z SF �F (Z. <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />� i1��2�00 <br />�-1 <br />Contract Price of Work <br />',\\ �.o..� � <br />Contact Person (Pian Rovfew) <br />1 hereby coriily fhaf 1 have road r+nd oxamined fhis apE�licafion and know 1he same fo be truo and <br />corraci. AO provisions of lews and orrlinances yovemmg thls type oI work �vifl be complelod <br />whefher speclfied herein ornot. The yrnntlng ol a pormit doos not resume to give aufhontylo <br />vlolate or cancel fho p�ovls/ons o! any otho� sfato orlocal law reguPtlnp construction or the <br />performance o( cons(ruction. That I pm authorzod by tho owner of this propsrty fo perfonn fhe <br />work /or which oppllcofion ls rnado and I comply with fho Stato Contractors Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />r" 1 �� <br />���Lj"Uf) <br />