Laserfiche WebLink
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.5ov <br /> �Z <br /> 5V--- (c) op; icrr-- <br /> PROJECT ADDRESS <br /> C, PA .£X' lUb?S P•0 r X v-{R Lk STI-VPPC _ IA C.-8, <br /> Owner Mail Address City Slate/Zip Phone <br /> PkVR <br /> Tenant Mail Address City State/Zip Phone <br /> J.K. Robert Construction PO Box 299 Lynnwood, WA 98046 425-75.0-0740 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> JKROBKR851 CO * rrf.o.c <br /> State License Number(required) City of Everett Businbss License Number(required) <br /> ) <br /> 1.J w P pt-31 t-L if 2 IRV • up <br /> Proposed Use of Building Contract Price of Wbrk <br /> ?it( Bo Burkett' 425-280-5037 <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: )ger / r " t Orr— gN 72 7 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 So <br /> a <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 15 0 7.--Z03 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 1/1/Cat— <br /> ( '- <br /> Signature Date <br /> REVISED 08/08/2014 <br />