Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <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 /> [ Lt- 0 lo(oK fi 5E 6 <br /> o <br /> 1(;11PROJECT ADDRESS <br /> 04L LLC___ J pct 21 gaff. <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> E+ frt2`f `f,k.£1 e�1n, e-/?f`337537 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> v...) . <br /> I`t-ef 93c 1J IF <br /> State License Number(required) City of Everett Business License Number(required) <br /> Li P e--)r, <br /> Proposed Use of Building Contract Price of Work <br /> PkCt,)L. C-4 90 .0,12_1/)-4_e__ <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: `'t 00 f� SO v1 � g/C. <br /> w <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 .75 D <br /> I hereby certify that I 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 any other state or local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the E I j) 2, o g--) <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WA . <br /> -r.....----_---__ a -�ori <br /> Signature Date <br /> REVISED 08/06/2014 <br />