Laserfiche WebLink
ELECT ICAL PERMIT APPLICATION <br /> ATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857- i tv u.}-e ife-Ke '4 041 eld V <br /> eIt((LI1`. . . .reA-.et/e-re,t1 Wd •j€1 � �r <br /> 8 *I LANt 1 ) <br /> PROJECT ADDRESS <br /> Owner Mail Address <br /> City State/Zip Phone <br /> Gftvlf`i) 6CVO pr.5. <br /> Tenant Mail Address <br /> City State/Zip Phone <br /> 1 <br /> i' t c'z-n2 >>o isv- 4A.,,D ", i t)D s <br /> (LI n,2- 2017. <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> b‘.kt.t I. ?30(6 L/1 v bI1 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> 1 ^� &%i t.l T;- -Y1W `Q? Li NV. 4:'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: CCS11"-eIiL./ tri'=Zy,y SH'v i N l: rL,0'(.. :\L614,167v1- L <br /> p.\ IIy L> - S , Z Gl i€--C-LkA <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 31054 5D oO <br /> I hereby certify that/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 l am authorized by the owner of this property to perform the E 5-bol Vf123 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 7/02/0 <br /> Signature ? Date / <br /> REVISED 08/06/2014 •3 I'/_t 7Z) /-14 <br />