Laserfiche WebLink
ELECTRICAL PERMIT APPLICAT'ON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />3�za rl������i ,��. <br />PROJECT ADDRESS <br />Un�� <br />Owner <br />UN i(1�G <br />Tenant <br />t� S�tia�isriCS�^ L�n'� 3i2O !�� <br />Mad Atldress <br />� Slw�aml�� �n� <br />Mail lldtlress <br />�r��zr�.-� �v, � 2i <br />Mail Address <br />�vEi2��.���2� 3 <br />Slate License Number (required) <br />Proposed Use o( Building <br />City <br />31�0 Mcl)a�� <br />C�ry <br />l�xnyon S-� <br />Crty <br />Square Footage (If residential new conslruction, remodel or addition) <br />2 <br />Numher of devices (If low voltage) <br />Description ol Work to Be Done: J-n5�""�� "" <br />CITY OF EVERETT LOCAL SAIES TAX CODE IS 3105 <br />fs��f �! `GYJ � <br />y -l6 -�� <br />�. �ve,<.i� wh �j'�"Lo l <br />StatclZip <br />r.,�� �(. E�.z.,,b! �wA <br />State2ip <br />. y.��t� � � `r �i gl og <br />State/Zip <br />Phone <br />�y�o1 <br />Phone <br />?o�-"lbi - <br />1 i`i`� <br />Nhone <br />Ciry of Everetl Business License Number (�equired) <br />Comrect Price oI Work <br />Z,,,c-�v3- i�44 �.r, iti-r <br />��c,riii�a f� L�CY S C( ru,nti �.c, c.+� <br />Contact PcrsonlContact Number/Email <br />Cz� ����-I�s <br />I hereby certify thaf I have �ead and examined this applicafion and know the same fo be true and <br />conect. All provisions ollaws and ordinances goveming thrs type of wo�k will be completed <br />whe(her speci�ed herein or noL The granfing ol a permit does nof presume fo give aufhonty to <br />violate or tancel the provisions o( any olhe� sfate or local law regulafing construclion or the <br />peAormance o/ cons(ruction. Thaf 1 am au(honzed by the owner o! fhis property to pedorm fhe <br />work Ior which applicafion is made and 1 comply with fhe Stafe ConVac(ors Law 78.27 RCW and <br />296 200 WAC. <br />2 <br />REVISED 08�06?Oia <br />f-EE <br />So�' <br />PERMii# <br />E l�fo� - c�oa <br />