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.org <br /> 3702 Broadway <br /> PROJECT ADDRESS <br /> Sammy Siad <br /> Owner Mail Address City State/Zip Phone <br /> Shell gas station <br /> Tenant Mail Address City State/Zip Phone <br /> Emerald electric Nw 9830 220th pl se Snohomish wa 98296 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> Emeraen902dt <br /> State License Number(required) City of Everett Business License Number(required) <br /> $2850 <br /> Proposed Use of Building Contract Price of Work <br /> Joey COSTELLO 4254461003 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Joey@emeraldelectricnw.com <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: Replace fuel dispensers with new <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I/�D <br /> 1 hereby certify that l 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 <br /> performance of construction. That/am authorized by the owner of this property to perform the E <br /> work for which application is made and l comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> /C/ 5-15-16 <br /> ignature L#100Date <br /> REVISED 08/06/2014 <br />