Laserfiche WebLink
To: Page 1 of 1 2015-09-04 16:55:17(GMT) 18006480341 From: Foy Group <br /> cul <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.gov <br /> 2-4)7./-1 u eve <br /> PROJECT ADDRESS <br /> vrr Gfi� <br /> OCC- j( V1 Z),OAEF-Ct.t M- PA/6 e----`'r - WF'r `l$?A', gzS-252•?zv <br /> Owner Mall Address City State/Zip Phone <br /> 11 I' e, .0 <br /> Tenant Mail Address <br /> City State/Zip Phone <br /> '1f Fig( ev2Due T.ifDU Ntt erou4b'r.ek-1164411-t->E L1/4)F} ctStri Me-g31-io.so <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> F-0Y6176Cfmp3t-K (St-1145(Qg <br /> State License Number(required) City of Everett Business License Number(required) <br /> • 614ttzu-k _ -Mr 1�=rft- AL 4 IWWO,00 <br /> Proposed Use of Building Contract Price of Work eAr aAS+A,ti <br /> (_}9BQLI!- LEES <br /> el.1 .4®F�o►,rc2ooP.NE- Zo r bz.-iDSte <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 Dane: EC..biJ F'&0(20110&) F ( ) tSTr/06 0 2Ci.. T5 Fad <br /> 14\tra(-- C- bt s - - 1) 10/16 C.t) u <br /> • <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 12 <br /> • <br /> !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 theo�/ O n n <br /> E L <br /> performance of construction. That/am authorized by the owner of this property to perform the i//� <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Sig ature Date <br /> REVISED 08/Q8/2014 <br />