Laserfiche WebLink
ELECTRIC�L PERMIT APPLIC�►TION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — vvwniv.everettwa.org <br />��I� V����� �� <br />PROJECT ADDRESS <br />�� I �- i�����P � 1� ���� t�� �����1 �---���u:����l�r <br />Ov�mef Mail Address City State2ip Phone <br />Tenant <br />Electrical Contractor <br />Mail Address <br />Mail Address <br />�mN�M �+g�7 �� <br />State License Number (required) <br />Proposed Use of Building <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 />City <br />� vv�a8�o <br />c�ty <br />State/Zip <br />State/Zip <br />Phone <br />25q t�l�l�(� <br />Phone <br />�� ���� <br />City of Everett Business License Number (required) <br />���1; <br />Contract Price of Work <br />Y���;-� f� ��c;►et�� 2S2`5�'�r <br />� Chn h,�t� � ; �w1 <br />Contact Person/Contact Number/Err�il , <br />� <br />1 hereby cerfify that I have read and examined fhis application and know the same to be true and <br />correct. All provisions of /aws and ordinances goveming this type of work wil! be complefed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate orcancel the provisions of any otherstafe orlocal law regulating construction orthe <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />�vork for which applicafion is made and 1 comply wifh the State Contracfors Law 18.27 RCW and <br />296.200 WAC. <br />ature <br />REL'I SED 08i06l1014 <br />FEE <br />/�/��� <br />� (.J -� <br />PERMIT# <br />E < <� <<'C� <br />