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 /> I U <br /> 2- <br /> PROJECT <br /> PROJECT ADDRESS Z (0^rl lc) --53 L13 <br /> 20 3 Cye 14t I,m 19 c,6'2—(-)Y <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> za 2,6 f� " 11y`2 S• Ke.n-l- � 01b'U31 Z5 3 �� <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> �roTEbAVS3'S? 3 r74K3 <br /> State License Number(required) City of Everett Business License Number(required) <br /> «— <br /> Proposed e of Building Contract Price of Work <br /> lvw,-�W 2,53 -3C1y` I0Sy <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> S <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: L, ' c5��.� 2 P4A <br /> C-e I l c M M un i ce~Ayv-3 P4A A <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 6 I�e bo <br /> l 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 other state or local law regulating construction or the ( T1— <br /> pe `�'D�� <br /> rforman construction. That/am authorized by the owner of this property to perform the0 <br /> work for which ipplication is made and/comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> SiIt,a re Date <br /> REVISED 08/06/2014 <br />