Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
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 />c� �} �� � ���✓,�'W6L�5".� <br />PROJECT ADDRESS <br />L vv�,� ; f 6 r�� �" s r�r� L �-�,�k�T- �.�� r���� � <br />Owner Mail Address City State/Zip Phone <br />� <br />Tenant <br />Mail Address <br />City <br />State/Zip <br />Phone <br />��►� L E.t..Ec. z►�t�. ����'t I� 1'J ��.i.t,lr-NLL l�v� F_ ��,� a- i� r 4f,v � ti.� s-.? 5�-►��i� <br />Electrical ContraCtor Mail Address City State/Zip Phone <br />i�l�b#l.e'Ei �1�LGin <br />State License Number (required) <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />l.l � G O �-7 <br />City of Everett Business License Number (required) <br />�� ��,�r, .r <br />Contract Price of Work <br />��I�t ST�U�hIS .31�U "t. L t -d5'[ 1 <br />t�is��v�N� @ei�.�.l �� ee�v� i� ,� G:v� <br />Contact Person/Contact Number/Email <br />'P �I� <br />Description of Work to Be Done: �� � Y 1--� (-�= ��G`i� I j �-�G`-�� 1/ l�l � /�/'l /�� <br />'� t n �t <br />� ✓�v 0 < <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify thaf I have read and examined thrs application and know the same fo be true and <br />correct. All provisions oflaws and ordinances governing this type of work will be completed <br />wheiher specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or loca! law regulating constructron or the <br />performance of construction. That 1 am authorized by the owner of thrs property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />i <br />���� ,�,� �`��1� <br />� <br />Signature <br />REVISED 08/O6/2014 <br />Date <br />FEE <br />�?g��,� <br />PERMIT# <br />E � �"� �? - � ��. <br />