Laserfiche WebLink
• • <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 /> r.DOOo 23 �d D q-- v 7-- <br /> PROJECT ADDRESS <br /> Ca 23 0 t., . ^2r"t�" v.„A - 5.2`2-03 �d 3$ `f 2 vo <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> ?A6lPc Fige- r (8243 paa,r9-g Pc , utA. 4'8Ny _-i8i �3�8rS <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> 0 <br /> .- c o ao <br /> 111 Ah V�AG7vQ� <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 /> '?—ate - ? '/— <br /> Number of devices(If low voltage) Go"— <br /> Description of Work to Be Done: *JD I Lo c A-i pelf S t' - f C o✓. <br /> E X( 5 i�1 �( -C A Ur4 S 4 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 2. Q <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 D( � ©� <br /> performance of construction. That 1 am authorized by the owner of this property to perform the E U <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> gnature Date <br /> REVISED 08/06/2014 <br /> 4 <br />