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.org <br /> / 3zS X Cfreir7 /l4/11-1 YA '► <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zi Yzfhone <br /> Thkr. 12 tis g&c 4 o r/nsfl 7- , tib 1a0'� <br /> Tenant Mail Address City State/Zip ( / Phone <br /> F iiO fA S /2)8 gar' r f EP/1*/� 7/A4 x-2/6/ <br /> Electrical Contractor Mail Address City Sfate/Zip Phone <br /> (-144411ifS1 d I, ( 3 et. 3 <br /> State License Number(required) City of Everett Business License Number(required) <br /> T6 kr 49v <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 /> Number of devices(If low voltage) le /J/10 <br /> 4- <br /> /L / ,� f/� <br /> Description of Work to Be Done: L /6 11/ /uz LO <br /> /0 F/��°� 1 k ii T)re& <br /> A /�-1 e�r�'" L i6/L t /�X /i o W`(�R. 1'L%(14-13 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 • <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 1 am authorized by the owner of this property to perform the E <br /> work for which appl. ation is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> fr/A45 '0A <br /> a re Date <br /> y2 )7/ )2 )S <br /> R. ISM 08/06/2014 <br />