Laserfiche WebLink
• AO- -- _ _ <br /> ELECTRICAL RMI T ,A PPL CATIQN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-- u/t U t/J- rew, ,:- -4 Wa..L <br /> e tint,* I .Elora.. .e,S wet- d+� <br /> PROJECT ADDRESS <br /> Owner Mail <br /> _.. . . .._._ <br /> Address City State/Zip Phone <br /> Gtuai!dt :7 w` . <br /> Tenant Mail Address City State/Zip Phone <br /> 1'/1V 1.D (Ail. Etter--Tl?-I C: lib r>o X In-4-t r:.4r.,f) <br /> "s `I Li15" S Las 2Z lc It <br /> Electrical Contractor Mail Addross City State/Zip Phone <br /> IN•(*.IA 1.t x 73 4`6 �,�'( L(.�.(; I <br /> State License Number(required) City of Everett Business License Number(required) <br /> QC 1.5•k 7 s a <br /> Proposed Use of Building Contract Price of Work <br /> IT&Ina,114-11J SC. - p.i t4i47^, /111x.!LjNV 1 .m <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: C.cCitAeliL/ r:-?sq:Z;t,y 5•:\v 1J i. tl.c-rc,::1t�cVyt67v j- XIL% <br /> ¶1.'r A\r 1 141 NI t-t )S �t2uut TS <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ° <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 t J I I -�/„(a <br /> work for which application Is made and I comply with the State Contractors Law 18.27 RCW and lU <br /> 296.200 WAC. <br /> t ,, , • <br /> 1a1a0� <br /> Signature f Date, <br /> REVISED 08/01/2014 �j 1. L To L f/�i <br />