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801 COLBY AVE 2016-08-17
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801 COLBY AVE 2016-08-17
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Last modified
8/17/2016 10:48:21 AM
Creation date
8/17/2016 10:48:21 AM
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Address Document
Street Name
COLBY AVE
Street Number
801
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• <br /> 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 /> 16G l Ccw,/ Ay6 <br /> PROJECT ADDRESS <br /> C_A 23LA- k) <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> 32,02-_ tCS"t <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> �Z 3 5 ecl <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ` I <br /> I hereby certify that I have read and examined this application and know the same to be true and A ` .O <br /> correct. All provisions of laws and ordinances goveming 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 E <br /> performance of construction. 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 Law 18.27 RCW and <br /> 296.200 WAC. <br /> �rZ-H1 <br /> Sign ure Date <br /> REVISED 08/06/2014 <br />
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