Laserfiche WebLink
• ! <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 />�� A� �U��� ��v� <br />PROJECT ADDRESS <br />ZGt, i I i ��, L U��i' 1 I��2 1��fiN�e /� -��/I�` i� �� .�. �Ze� l <br />Owner Mail Address City State/Zip Phone <br />Tenant ���; � /,h� �` n� re ` G VV '�� City State/Zip Phone <br />' � �i � b <br />��)�.s��� So�r�U ?��� �.GC�,�.(��a�S�.-�I���1���� i��.��z��' <br />Electrical Contractor Mail Address <br />Ul��i S�'�'>S � �� 2 � <br />State License Number (required) <br />�/ � <br />< <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />2 � ►��n I� -Fr�� <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />s�;1�,� s s� �v�. <br />,� <br />City � State/Zip Phone <br />� ?�U �-� `-� (�' a � r'�''1 <br />r�il�� <br />City of Everett Business License Number (required) <br />Contract Price of Work <br />Contact Person/Contact NumberlEmail <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 G� (%� �l �� <br />�� `� <br />! hereby cerfify 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 nof. 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 � <br />performance of construction. That 1 am authorized by ihe owner of tliis property to perform the I�U ��� 2� <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />�b�, U� �I � �V" e1�� � �2� �2� I� <br />Signature � Date <br />REVISED 08/06/2014 <br />