Laserfiche WebLink
Jul 21 15 04:43p !vs x8919232 p.1 <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 /> (6cc 5e tl Lir /44-/( �'•�Y <br /> PROJECT ADDRESS <br /> /4i4(4 i • <br /> owner Mail Address City State/Zip Phone <br /> //tJ C.r1 fLf <br /> Tenant Mail Address City State/Zip Phone <br /> 1-4.; , Jam: S Eov%ir f i Lavi--Gs _-574, ( 6 t :,frav t-f4<:E.-:Gt 7 W / ,li5W,-5—j <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> Z- stir r £d was�J. po c2- r <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> • <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> •2- <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: t/ < f C�.S SSC.ui)4l e e,-4 t i. (r;,;c, C s'i' <br /> • <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 it <br /> /hereby certify that!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 otherstate or local law regulating construction or the E N60-1---00performance of construction. That I am authorized by the owner of this property to perform the / <br /> worts for which application is made and i comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 771V4<,_ 712-r-/5-- <br /> Signature <br /> //.SSignature Date ' <br /> REVISED 08/66/2514 <br />