Laserfiche WebLink
---- - -- –� ---- -- ------— <br /> ---- �----- � <br /> � <br /> I <br /> ELECTRICAL PERMIT APPL�CATION ; <br /> CITY OF EVERETT ?ERMIT SERVICES '� <br /> 3200 CEDAR STREET, EVERETT, 'JVA 98201 II <br /> 425-257-8810 - FAX 425-25?-8857 -www.everettwa gov <br /> C I 5 U,y -'6 �ks <br /> I (� ,. ag_i s <br /> ' L�e ree UJ� <br /> PROJECT ADDRESS I <br /> I So,,.�4-l�� t��,� ��f ��a zA �101a�11�nn 5c h �. f�c�c ��cTU Pz c? � �_ li <br /> Owner Ldai�Atltlress Crty StatelZia Pnone <br /> l�h�.���e VJQr .� > g�_1o�'� ���rc�ree�, ��'��eve��- � �A Q .2�� I___ I <br /> Tenanl tt�ad Address Qty Stale2p Pnone : <br /> i <br /> i <br /> � I�s�nSo,� ' ,�.� �f� �»x9�f'� �� ��evc�a �e t,c� b q'Pz3f33 360-1�13-4�c� <br /> , Electrical Contractor J rt4a�i A.^.aress c;y StateiZ�p Nnor,e � <br /> � -�, N f,n/SOSG � . � �5��'Z� �,I� <br /> i � „ � ,-, � -, . i n a M � i <br /> � <br /> State License Number (required) Gly of Everett Business License fJumber�required) <br /> �C'.�C'�_I � f I c-� r���U"J�;�� <br /> ,�✓sT <br /> Pwposed Use of 9uilding Contrecl Pnte o(!Nork <br /> ConlN i� , rY1 n,cr e r,�ula UC' c� �� -���I <br /> Square Footage Qf residential new conslruction.remudel or addition) Conlact PersonfCo act t i mberiEmad <br /> f <br /> I ; <br /> Number a(tlevlces Qf lor+voltagry <br /> I <br /> z 1 � <br /> Descriplion of Work to De Done� ly����y)�(�] L�_� �a�h�--��L� e�.5�v � <br /> �� <br /> ` '� UJ e 5'�' .�i(1��'�l S�` -{- ��e�_SL��t?_a)_S—O�� S__IL� � L�— <br /> � o�,�, � � e.,z �� <br /> �.� r C.v���s yv�� �0���� P� S _ � <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ���i-�`� O j I <br /> 'Ju <br /> !hereby certdy thaf lliavc reaU and exam�ned this applir.a(ion and kno�v the same fo Ge We and _ <br /> correcf. AN provisions o)laws and oidinances gove�ning Ihis type of work will be completed ---� <br /> �vhefher specJied hr.rein or not The granfing o(a permif does not presume to give authority to PER��I IT" <br /> violale cr cancel lhe provisions o/any ofher sfale or'local la�v regulaLng construction or the /� <br /> peilormance o(consWction. Thaf 1 am aufhonzetl by fhe on�ner ol this property fo pei(orm fhe E ,5�(/I �O� 5 � <br /> �vork Io�which applicafion is made and I compfy�vifh the Sta(e Conhacfors Law 18 27 RCW anJ <br /> 296.200 WAC. <br /> '�-����nd�I 'J!�1�'I 9 � � � I � <br /> Signalure r �1 Dale <br /> U <br /> F@VISED OP105/10 f a <br />