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 /> 2- H o <br /> PROJECT ADDR SS <br /> �—'"l -_ �- $12 t-0 oyt AN c y we.., 6✓cy-e�t- lA q 8201 <br /> Owner Mail Address City State/Zip��Z5\210_ �POho 2 <br /> zj <br /> T ant Mail Address City State/Zip Phone <br /> IN"-kV X VA S OX a..(- '10 Li l RA3OU-PRA %t'e.,A '5Q.Vl�K-w lel]111v q�U2 6 <br /> Electrical Contractor Mail Address City State/Zip(-4-4.,0-7L16 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Bbilding Contract Price of Work <br /> f�.( a K e_ �V--e�fo, (%0�9U-0851 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> afi 2.�V`f QSi�.Y fl SO l 0.01 Y�C.C_c7(n <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: ria��� Q� f Y(U&K-Dp <;-U�IxX' �y Sy-'-texy\-}p 1 n Gl l3a-q-; <br /> �-zw He 1ryioau lig <br /> C (� 1-t-eKr9� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 0 <br /> I hereby certify that I 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 l am authorized by the owner of this property to perform the <br /> work for WJ�ich,a is de and l comply with the State Contractors Law 18.27 RCW and <br /> 296. Ob WA <br /> 1 <br /> Signature Date <br /> REVISED 08/06/2014 <br />