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.gov <br /> LOI Di A"a/teg(i. 61 vA' - -f3°.'n ''' <br /> riIt% kL, ,k \. S. <br /> \ . "A - <br /> PROJECT ADDRESS <br /> Owner Mail Ads (\010 yj , C� tt_yet 4 f3\3 - j Stat o Phone <br /> C \c� C\:\,0o( L3p (ext t Oc-, r6 <br /> Want Mall Address \ \ C tO (�1` State/Zip Phone <br /> - ))(L13( ht--) cc):CC-Ar\ CiN Cl(t) 1 ''qt.'a 44 R-0() <br /> Electrical Contractor' Mall Address City State/Zip Phone <br /> ( -c-A.) =\\\\ \- \ \\ <br /> State License Number(required) City of Everett Business License Number(required) <br /> i 11T t6 r\ r4 7(required) . <br /> (a1 ��I ' ,\` A G� \ CDC <br /> C <br /> Proposed Use of Building Contract Price of Work \ <br /> new construction, remodel or addition) Contact Person/Contact-Number/Email <br /> Square Footage(If residential <br /> r \\` <br /> w 1 \Clb 0,,A-\\€;-\163 <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: C-Q 0`��\` ? �i�,,V ` V�_. <br /> FEE ,e <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 f 11Ht �--- <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 he provisions of any other state or local law regulating construction or the <br /> performan - o onstruction. That I am authorized by the owner of this property to perform the E l l D— C 1 <br /> work f• application i ado and I comply with the State Contractors Law 18.27 RCW and <br /> 296. 00 ''C. <br /> _ 7/ \�\ <br /> S\/ <br /> Sign ure Date <br /> REVISED 08/06/2014 <br />