Laserfiche WebLink
� <br />� -- - <br />ELECTRICAL PER�VIIT APPLICATION <br />CITY OF EVERETT PER!JIlT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 �i- a.b -� 7 <br />425-257-8810 - FAX 425-�57-8857 - www.everettwa.org /cp �D y-.I �( � <br />APPLICATIONS ARE ACCEP7ED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />� � <br />�_��C_. I( i'i i��t!- '>� ')�., �1�����i ��_ 1�;�'� � y <br />owner Mall Address ciry si,i��zn rn�oe <br />>P11�i�. /)�� / )�Jc��!L <br />Tenant Mall Address Clly SlalelZip phone <br />��- <br />>���! ��i� ������t( �-��>>) �C-t���c �-1�� ��f � (x'ti'r'i�� l._`.(. ��1������ � <br />Eledrical COnl�8d0� Mail Address Gty Slale2ip ph-�ne <br />� ��'��' '�'.l) <br />SlatQ License Number <br />ProposeJ Usc oi �uildiny <br />Description of Work to �c Dcrn�. <br />NOl L. V�'IRING IN NON-UW GLLINGS IS RfOUIRED TO <br />f3[ IN RACEWAYS, MC OR AC C�[lLE <br />CITY OF EVERETT LOCAL SALES TAX COUE IS 3105 <br />� � ��l'�1 <br />Conlract Price of Work <br />Conlact Person (Plan Review) <br />I heieAy ccrf�ip fha( I have read and exe�mmoA fhis appnrnh��n ond know thr same fo hc tnie nnd <br />nonnct All p�o��isions of laws end ordinnnces gnvr+rnrng fh�s tppp nl �rork ����116� cer,r�.•!efed <br />whefher specil�ea herein or nof. The granfin,q ol a pennd Ooes not pmsume to �i��e euthonfy fo <br />viol�lr or cancel fhe provisrons ol eny uther stafe o� Ixnl law re�ulabng conshuction or Ihe <br />peAnrmmice ol censtruclion Tha(1 am aidhonzed by fhe owner ol pus property to pe�fonn f/re <br />woiF lor whirh eppGcafion is nmde and I comply wifh fhe Sfate Conhar.�ors Lew iB77 RCW and <br />796 200 WAC. <br />--- -.�.�„� �----� - -- - --.- _..i;;�n,--- — <br />FEE <br />