Laserfiche WebLink
• • 1 <br /> ELECTRICAL PERMMMrI APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 — 1.�1/wt.()-e i' KZ:t e+l4.y V <br /> r lv,(L� I'. .evare4-f.e ps gd cve-i,6 we- .i o v <br /> 3 16,..- (, ( i_> (, . l--) <br /> PROJECT ADDRESS <br /> Owner Mail Address <br /> City State/Zip Phone <br /> Grzk4rsl)vtC.NJ G:'it r^c. <br /> Tenent Mall Address City Stole/Zip Phone <br /> t tcultt.LA EI,C6TR l6 Pb i3O n `i S11 VI 1-tomU,Ai-J,, G , ; <br /> w+ '. 1 t, 1. � s (i-17,s-) t,..1-z-201Z, <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> Al'..C 3 t;'o 0 <br /> State License Number(required) City of Everett Business License Number(required) <br /> • LPr)((fl L JtS .4. 660 c'6> <br /> Proposed Use of Building Contract Price of Work <br /> .-17-1 GiAs'.PI)•J TSC'-Y .c.D-1wYZ 11+v.)LiNV.,cimel <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: 01',C A-c- 1 _/CM: ;-j SAV i N(, Crei,e7LE1A167 crp. l.•t(„-i-r'c <br /> $A1-1-1 t\i`r 1 rtil;J i;e. Vii=1'J S 1 Z cut-t-w, 11`3 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 4 6-/ 5731 <br /> I hereby certify that/have read and examined this application and know the same to be true and 1 <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/t <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 5 I I - [\.:1 ) <br /> 1 ') <br /> work for which application Is made and t comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 11}4. <br /> Signature r _): a� av/5 <br /> r, <br /> i <br /> REVISED 08/05/2014 31.1-L 77) 6(—A <br />