Laserfiche WebLink
�o� <br /> � — � — ----� <br /> ELECTRICAL PI�RMIT APPLICATION <br /> CIT'Y OF EVERETT PERMIT SEHVIC�S � <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org �I _O�_ /Jc <br /> c- ���y� o� e , <br /> �y ��> 3q�� ST � � <br /> PROJECT ADDRESS I <br /> ���� ��+� �y� ►SLt"� � Nt, a�a.�,.a,�. �� �ex� � <br /> Owne� Ma�l Address Gty Stale2�p ahone <br /> \ �('�(� �\CL� <S� �V7 �,� �G7rL`��:CL �3i �<L1Vl"L ,��(�— <br /> -'c <br /> Tera�t hlanAndress G;y State/Zip Pnone aZ�� <br /> �xN��-t '�lu���- ybl l :��'.f`�c, f�u1- (�� ���A�___�c .�_ - RB�� ,��-3-y��-�� <br /> EICeI ieal ConiractOr Mzd Address Gty Stale:Z�p Pnone � <br /> � I <br /> ��0�(��-�G��L C� 'nla �tn� 1�15� �,� D'Y'ol.2SS � ,, <br /> Slal License Number (required) Cdy of Everetl usiness License Number(reqwred) <br /> �- cS' �56 .vv � <br /> L�� I S` � i��:o eC�u`•lOwlcu 1 � - I <br /> Proposed Use of Building �— Contrac; Price of Work <br /> I <br /> � a� a-� �- Yos�'jo� � tMnrtP�E.��x�t- <br /> Square Foo�age Qf residential new consfruction, remodel or addition) Contad PersonlContac� NumberlEmail `.iL��- ' � <br /> as3� �ga ,so�� .�-��-- <br /> Number of devices Qf lov�vol�age) <br /> Descnplion of Work to Be Done: G"rcc,���J � i���;y�v� {�a�S D Cc�C��• �/.c� S <br /> FE[ <br />' CI"i Y OF EVERETT LOCAL SALES TAX CODE iS 3105 � �� � �D <br /> I hereb}�certdy that I have read and examined fhis applicafion and knov�the same!o be lrue and <br /> conect. All provisions o/la�vs and ordinances govem�n�th�s fype ol work wdl be complefed <br /> whelher specified herein or noL The gran(ing ol a pennit Uoes not presume fo g�ve aulhonty to P[RMIT# <br /> violafe or cance/fhe provisions ol any ofher sfate or local la�v regulaling consWcfion or fhe ��� D � � <br /> per/ormance ol constn�clion. Thaf I am aidhonzed by Ihe oevner o/fhis property fo peAonn(he E + <br /> �a�ork lor which applicalbn is made and 1 comply rvilh the State Conlrar,tors Law 79.27 RCW and <br /> 296.200 WAC. ///�� <br /> / � <br /> % � �,-� � ���c/� <br /> S natura � Date <br /> nevis=nca.o�:��c <br />