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 />�� �� �, I i 1�a � i� � i/� �Jt? i� �E'� G��' � l <br />PROJECT ADDRESS <br />����Pr� f'�1i�l�i`� 3v�F-� i����l;�/+�� �-v�Y�c�� �.��1� �°��-�l ���� Y�3�t�r <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />�� (/�� � r � � 1 � � <br />Electrical Contractor <br />State License Number <br />S �-- � <br />Proposed Use of Buiiding <br />Mail Address <br />Mail Address <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />� %�/t f�i <br />City <br />City <br />State/Zip <br />State/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />1 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 noi. The granting of a permit does not presume fo give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or fhe <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />work for which �ppJ��cation is made and I comply with the Stafe Contractors Law 18.27 RCW and <br />296.200 WAG': � , <br />, ., <br />� � /�� � '� '��J f � .`� � <br />1f L'' ( ; � %� / f� -", %r— / � <br />REVISED 3/20/13 <br />FEE <br />�75 � � <br />PERMIT# <br />Ei3�8- iZv <br />Phone <br />Phone <br />