Laserfiche WebLink
Nov. 3. 2015 8: 58AM No. 0744 P. 2 <br /> 0 ___O___ . <br /> 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 /> PROJECT ADDRESS <br /> r-., <br /> r <br /> / ,- ` I i. ,:fit\l <br /> (,,,..17 .1:2)1 <br /> .1: 1 !.. 501\ -L/. T; P ti. us-.. "1 L• s <br /> Owner Mail Address City Stato/Zlp Phone <br /> Tenant Mail Address City State/Zip Phone <br /> (_- S 1 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State Licenso Number(required) City of Everett Business License Number(required) <br /> Li l f; >C,a. 00 <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/ContaCt Number/Email <br /> Number of devices(If low voltage) g <br /> • <br /> Description of Work to Be Done: ,1.-C. t r(..t.' {-l•; ``�! ) ���i�(�CA e e_t_ t-'t C.cC.0 <br /> t )• <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 '1 5I°('I hereby certify that I have read and examined this application and know the same to he 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 Clore not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other stato 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 15' 1 — D(7 <br /> work for which application is made and I comply with the Stale Contractors Law 16.27 RCW and <br /> 296.200 WAC./71 <br /> ______4:117C- <br /> Signature <br /> i 1(7 <br /> Signature ate <br /> nE VISEU aW06,IO rQ <br />