Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wviw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�zl � �� � �-� C-I J� L�t s <br />PROJECT ADDRESS <br />�C,��,1—D a7 <br />�L�F:,C� I75u��c� 1�7�' l�r;-�r. �2 /%�� Sc;ll� G.�t9 9c�1 �/ l�S�Z�%sT�/ <br />owner i,i,n aad��•�:s c�iY si��e2�� Phonc <br />Tonanl <br />F.1;iil AdAre55 <br /><;ily <br />Slale/Zip <br />Phone <br />n;�,. _ r�,��{,� (��Gc�� �? c�cn� ���1�<�.�� �,u,�1 ����� y����s� <br />Eloclrical Conlraclor hlail AdA�ess Gty Slale2ip Fhone <br />�P! r� �'; �J3 `I ti�� <br />Slalo Lir.onsc Numbor <br />` r, � <br />�,I 0 � .. _ _> i �-ti-i � ; � � u,. �� ..��i; , �L <br />Propus��d Usc ol Bu��din�� <br />D�scriplion of Work to On Dunr,�. ��E�l.�% <br />NOTE bVIRING IN NON-DW[LLINGS IS REQUIRED TO <br />�E IN RP.CEWAYS, MC OR AC CABLE <br />CITY OF E\�ERETT IOCAL SALES TAX CODE IS 3105 <br />3k�D <br />Contract Price of Work <br />�1�, i�1'!�'1 � <br />Cor.t�cl Person (Plan Roviow) <br />I heri�hy <<�r6fy Ih;if I Irav�� rend nnd rx.i�mneJ flus npplica6on end know fhe serne fo be hue and <br />n�nrr.t �ll pravisn�ns ollews nnd nrdinrincos puvornuig Ilus lype ol work ivill be completed <br />whofhr�r spoci6c:d hrrem o� not 7hr p�anNn� o!a pernuf durs nof n�sumc fo give aufhont}� fo <br />��mlefe n� c;mcM fhe /��ovis�ons uf anp „fha stato or local lew �ec�u�ihnn consbucfion oi fho <br />�uvlorrnnnce o/cunsfrucfion lhaf I nm aufho�ized by fhp ,�wner o! fhrs pruperty fo peAorm !he <br />w�vA hn �am, li applrcetion is maJe nnd I comply wifh fhe Sfate Confracfors Law iB.27 RCW end <br />796 'T.00 WA(, <br />i � � <br />,_ '� ;.I ( ; � __ -- � � L��� <br />, <br />y<1- t Tli �,/) �) <br />FEE <br />�d��l �c-,� ) <br />