Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �,� _v 7 <br />3200 CEDAR STREET, EVERETT, WA 98201 I' <br />425-257-8810 - FAX 425-257-&857 - www everettwa org � U 7 p/- lU�� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />a(�'1-19.,"��,�r�,s���- ���e.r<tt, ���,i �S�7c�� <br />PROJECT ADDRESS <br />I� <br />CI��IFDVi�ilc���'zEr r'ti�Crft� <br />t� /`lalc�l N�`�115%-.'���.�i <br />Ownei tdail AJdress CitY Slate�Z�p <br />r;i1C�I�l�h1K)t Cl t�, U�mnt {'k'�ilili c.h. 9.D9�1- 11Z+��,�7tef ��J, �'ti�ercf�, <br />Tenanl <br />( c i�v� <br />Clecinc2l <br />Mad Address <br />�nt� Cec l�r��lc�j�� �,� <br />City <br />State�Zip <br />Phone <br />c��� 9fi2n�1 <br />Ahone <br />?a20ltih��iyeE't� {1�fc�✓r�l�, �ti�c�q84o`] <br />y� <br />( f�1�dPi'f ��`iG IlC <br />tilate License Number <br />Pioposed Use of Buildinq <br />Cdy Sta;e/Z�p P^n^^��, <br />� , ' %5?�2AZ $71Y <br />� �� 2`i� ��J, Gr=' <br />Conlract Price of Work <br />I�1cr > 5hre«r.�z'nt � <br />Contact Person (Plan RewEw) <br />Descnphon of Work �o Be Uone�. II)�,i1� �I �l��Ji( /)y T'7�"('('C I'C�l�l �r�( {�, �i-✓I k�"S, n�/1�'t M�(' I;l��- <br />�11)1�P� � IYl`�b�/�CAl.dl�)��Z�i" l�t�rli� �i�>>C�'S� k'�� ��:Z��S (Lt�li 1'CcLtiE'f.�,. <br />NOTE 1NIRING IN NON-DWELLINGS IS RFOUIR[D TO <br />f3E IN RACEWAYS. MC OR AC CABLE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />I hereby r.eridy fhnf I har�� ie,iJ and r� anuned fhis nPP6cuhnr, orrd know fhe admr, fo bo hw� arr,i <br />rnnr�:f. AU prov�s�urrs oll,nt c nnd o�drnances gavemmg fhis fypo of worA wdl be conrplef��d <br />i:�hr,ther sp�cilicd hen�in ar n��f I he �ranfmy o! n pennd doos nof /�reswne to gfve aulhmrt� 1� � <br />molnfe o� r.nncel tlre provisrons oI eny ofhe� sfnfe or Incnl law regul�ahng i:onsUvcf�on or fhr <br />pndonnnnce ol conshur.lion Tlrnf 1 nm aufhonzed by fhe uwne� o/ lhrs prapc�ly to per/nnn fNr <br />n�ork lar which npplii+ihnn is nmde and 1 comply �vdh fhe SteM Confr�cfors Lew 18 27 RCN,in,l <br />296 200 WAC <br />. <br />�_ ./� /7- �^ `�"` ----�� 3 n -------- <br />9 � - - �--- --- �=�- <br />. �r,:c,.�, - oate <br />FEE <br />