Laserfiche WebLink
09/24/2014 08: 24 2069575105 BLUE SKY ITI PAGE 02/02 <br /> • • <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES :/Y09--'3'7 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 c� ,-a(4 -14 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa_org <br /> NO6Pilt16- 270 --(38, E Fz-e 2 of/c e 6 k I• a 0/1-Pe7/7i/ <br /> 3003 k _ CO/A/O /2g -- /L-,--t -77- W/9 ). <br /> PROJECT ADDRESS I <br /> )0t,'()6-- 70, ( ?° 7 /{17/— 7—ZZ-C- w/9 Pe/ 2V <br /> ner Mail Address City " State/Zip Phone <br /> Tenant Mall Address City State/Zip Phone <br /> le4U/(9.<y./Al 6,1771) 3(5- // A s% /2( <br /> t•-• (�, <br /> Electrical Contractor Mail Address City Xate/Zlp Phone /, <br /> VE17 <br /> SSZ? z2- - D 9 i g o tt - < <br /> State License Number(required) City of Everett Business License Number(required) <br /> '71? R �( A , _ • 2t99 3W <br /> Proposed Use of Building Contract Price Work <br /> (2-<2c,j(71A ' � / qs /CA3 <br /> Square Footage(If residential new construction, remodel or addition) Contact Perkon/Contact Number/E1 --!`.-) <br /> fg d'kE6"- 7/f2c-01-(&61C--5/4 -L U. <br /> �'' ') <br /> Num er of devices(if low voltage) <br /> Description of Work to Be Done: --11/),c74-a_.—(>7...) / VS r (a) (-7&--(c.7-o --( 4o <br /> � 0/ 3/ (/yoCe(cz &- . / fll //t, <br /> rn)J9y71 e4& & 3j1c �� (Jo c.,( - - p-(/(c <br /> e9iev6 ivs. <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 r C` � z <br /> I hereby certify that/have read and examined this application and know the same to be true and `� (/(/ <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or cancel the provisions of a' other state or local law regulating construction or the <br /> performs +f construction. Th:�-.• authorized by the owner of this property to perform the E '�0 I <br /> 7 <br /> work for+ .j ap ' etion is .-i : I comply with the State Contractors Law 98.27 RCW and I <br /> 296.200 •• •dfl7 ' <br /> 06//gS <br /> - - ignature Date <br /> REVISED 09/062016 - <br />