Laserfiche WebLink
ELECTRICAL PERMIT APPLICATI N <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 /> PROJECT' ADDRESS <br /> Owner Mail Address Clty stateop Phone <br /> Tenant Mail Address city State/Zfp Phone <br /> Z5-776-811-9.. <br /> ElectricalContractor Mail Address City State0p. Phone' <br /> rtVe tqs QZ62-W <br /> State License N;,mber(required) Clty of Everett Business License Number(required) <br /> Proposed Use 6f;80ilding' Contract Price of Work <br /> NM4A4 WAL1 425-zt8-170 } <br /> Square Footage(If reaiden(i'al new constriction, remodel or addition) Contact PersonlContact Number[Em—all <br /> LA <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: µ�± '�� �� "� 1�1�� _� ,��-y I 1"" IX ! <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 , c 00' <br /> I hereby certify that)have read and examined this appllcatlon and know the same to be true and <br /> correct: All prbvislons of laws and ordinances gdverning this type of work will be completed - -- <br /> ivhether specified heretnor 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 conskuctlon or the ©/� d <br /> performance ofpconstructlon. That I am authorized by the owner of this property to perform the +� <br /> Work for which application Is made and I comply with the State Contractors taw 18.27 RCW and <br /> 296.200 WAC. <br /> L <br /> 5-19- 6 <br /> 8lgnature DAte <br /> HEV1gED 08/0 W2014 <br />