Laserfiche WebLink
From.Lorko EieOtr,C <br />42r. 7ae 7730 a6/U412013 19 42 n030 P. 0017001 <br />• • <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.org <br />9/3os-o5/ <br />-13 <br />L �— <br />PROJECT ADDRESS <br />Owner Mail Address City Slat rlip Phone <br />Tenant Meal Address Ciry Statelzip Phone <br />YZS755 ?7� <br />Electrical Contractor Mail Address City StatorLp Phone <br />%( _c�q C( - `Tatter % pyc� <br />State License Number contract Price 1 Work <br />i4�(Z� 11 S •k-Jw S _ <br />Proposed Use of Building Contact Person (Plan Review) <br />Square Footage (It residential new construction, remodel or addition) <br />Number of low voltage) <br />Description of Wark to Be Done. �1-Ci`y� �`" v ✓" Jy �' <br />FEE , <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 a, , -Jj-'r ore d <br />I hereby certify that I have rend and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this typo or work will be completed <br />whether specified herein or not. The granting are permit does not presume to give authority to PERMIT# <br />violate or cancel the provisions or 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 <br />work for which application is mode and 1 comply with the Stare Contractors Law 18.27 RCW and VV �� <br />296. 200 WAC. <br />Signature Data <br />REVISED "W13 <br />