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 /> t ° Ev'e yt er �Gy <br /> PROJECT ADDRESS <br /> Owner 1 Mail Address City State/Zip/ Phone <br /> • <br /> l JC ♦ . " `( 1 M-�{r,4`f C._ ti...�. .�`' 'c.v e f`C-1--rW Ufa S b �. <br /> Tenant Mail Address City State/Zip Phone <br /> A-RQ , kcL.re rx, CYs1,-5 9- T�.dL5--r� Pr, ..✓4 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> AQ'QL.+ !5 (9 ( 6 `2 bo( 524 <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: eQ, c� ea T �e <br /> a v..GI a co ve ovt.r- Re S-f r 4 , <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 /�'j► Z� <br /> I hereby certify that l have read and examined this application and know the same to be true and "✓ V <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 OP'? <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> C gs- ao\ <br /> Date 9 <br /> Signature t <br />