Laserfiche WebLink
0 a <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 /> • <br /> PROJECT ADDRESS <br /> r Po 6 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> £1.L4 L EL.E.0 1121e: 34iA it4L 6D MLL Avg E tizAs it t ci%10 i 4i.71-25".1-17PD <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 5114i4LEEt clI,Q121 1 a11-1 <br /> State License Number(required) City of Everett Business License Number(required) <br /> • <br /> Proposed Use of Building Contract Price of Work <br /> t i .L STrugrtS 3LeD `I.ft l-051 t <br /> dskeve.Ks@d.A.1,1 LLe.GthIL.Cbm <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number,of devices(If low voltage) <br /> Description of Work to Be Done: RePLwCe. f Y 1s?'1? . F6afOe TO C1411-4-6t <br /> VI—r l-f' to 0- ,vie figlAO <br /> FEE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 . 1("))2._ 9)();\ <br /> I hereby certify that I have read and examined this application and know the same to ba rue 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 I am authorized by the owner of this property to perform the E 1 ,g,0' \�work for.which application is made and!comply with the State:Contractors Law 18.27 RCW and - <br /> 296.200 WAC. <br /> I) <br /> ignature Date <br /> . .' REVISED 08/062014. <br />