Laserfiche WebLink
� <br />ELECT CAL 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 />� �) � V Q" i �' 1? fre-t Cl!c7 � (� �C� (� <br />PROJECT ADDRESS ��� �,z� 1-r/� <br />/��; �� ������ _ 3�a c�--��� S� �;����� �� �s��/ <br />OWner Mail Address City State/Zip Phone <br />Tenant <br />Mail Address <br />City <br />State/Zip <br />Phone <br />� �� <br />EleCtriCal Contractor Mail Address City State/Zip Phone <br />�?�( ��. ,�L�i ��C�- <br />State License Number (required) <br />��� :� / %r-- =��.� � I <br />Proposed Use of Building <br />Square Footage (If residentiai new construction, remodel or addition) <br />City o Everett Business License Number (required) <br />� O �� <br />, .tJOC� <br />Contract Price of Work <br />Contact Person/Contact Number/Email <br />/ s�t��to�s„�� �m� �5 Z�,��' <br />Number of devices (If low voltage) <br />Description of Work to Be Done: �2�2/7�oc�.c�l %r+,v �,/' �i�Ts'�ri � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I 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 <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform fhe <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />nature <br />REVISED 08/O6/2014 <br />uate <br />.S/z S'�i S� <br />FEE <br />����c : <br />PERMIT# <br />E � r �S--I�7c� <br />� <br />