Laserfiche WebLink
08/03/2015 02 : 08 #7111 P. 001/001 <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 /> 3oG� C GzAvr <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> C �C) vZI Z2= d <br /> Tenant Mail Address City State/Zlp rhone <br /> aL-A,Q D'o, S A [ <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> , V Z <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building L 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_ Q v <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 t s® <br /> /hereby certify that l have read and examined this application and know the some to be true and <br /> correct. All provisions of laws and ordinances govem/ng this typo of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority tp PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of const ction. That l am authorized by the owner of this property to perform the El <br /> work for which <br /> agP/i tion is made and/comply with the State Contractors Law 98.27 RCW and <br /> 296.200 WAC. <br /> o� 3 <br /> ig a ure Date <br /> RErsaooe�osnor4 <br />