Laserfiche WebLink
ELECTRICAL PERMIIT ApPLICATION <br /> CITY OF EVI�RETT PERMIT SERVICES _ f , �1 <br /> 3200 CEDAFc STREET, EVERETT, W�,98201 ' ' <br /> 425-257-SS10 - FAX 425-257-8657 -www.everettwa.org � //t7 S - a f= <br /> APPLICATtONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � .,,� <br /> 17J(, hT�ii SI , i vai��IL ';1'� 9R201 �Room G3191 � <br /> PROJECT ADDRESS <br /> i�Y <br /> Prondenrr h��4C i-r00.:-L'!a 51 . jRnum L:3191 � �„�rr;l' N,�A 9P201 <br /> Owner MailAddress City State/Zip Phone <br /> 1°� <br /> {'r����ul�:n�.�, R�1C 17frt1 �};;ii 51_ (Iloora E314i11 I_w�rcll WA 98201 <br /> Tenanl Mail Address Cily StatnlZip Phone <br /> Point �n Poinl I_V ;��rvir,i�s 200�1 1961h SL SW Lynnvrood WA 98036 425-771-7257 <br /> Eleclrical Conlraclor Mail Address CAy Stale/Zip Phone <br /> POIM PLA90D9 55.000.00 <br /> Sla�e License Number Contracl Price of Work <br /> �,=`"'�"':'==`�+���- l G-L.�� ��.� SlePhen UVeeF:s Ph -025-344-1452 <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Descrip�ion of Work to Be Done: N��'�� ��������rurlinn lu�.� vr.l�a��;t�^nnnq insLdled in walls �.viln limded condwl mlraslrur,lure <br /> I� i iind �ind outr o �ytil �im� Incl�ll�linn �in I I �ii�ii�i,�P.nn �-f tnin d�:�vices. �- �$lJl Co t <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � <br /> I hereby ceriilv thaf 1 have read and examined Ihis applicaGon and know(he same fo be true and /— I��� _ (�� <br /> conect. All piovisiau ol la�vs and ordinances gove�mng this type o/work wiU be cornplefed U <br /> wnefher specibed lierein u.�noL The granicig o/a pemut do��s nof resume to give aufhonty to <br /> violate or cancel(he piovisions o(any other stafe o�local law re9uPting conslruchon or fhe <br /> pedorrnance o/consfruc6on. Thaf 1 am aufhorized by the owner ol this property to perform the <br /> work lor which ap�licatiai is nade and I co�np(y wifh the State ConVacrors Law 78.27 RCW and <br /> 296.200 WAC.� � 1 ,/, / <br /> ��� � . � <br /> � , <br /> � ���' ,'% vr�j� � O�i-OZ-11 <br /> � Dale <br /> Si�nalure <br /> c <br />