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 />���' �'� , �� - - <br />�l 0 � -��1� ��i ��!%/� <br />PROJECT ADDRESS <br />�� w'9��1 �n�������sF� 3 9» c�,�✓�y c�,���� s����� ��1�� z��-��q� <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />,��vw'i✓ ���i2 C��C G✓� <br />Mail Address <br />City <br />State/Zip <br />Phone <br />I✓,���°"i� S� 6n/ Cd�� 1 zS� (��3'%%l�g�'�' /`� S�/I-77G� 9�1D9 2a6- ?��2 -Ojp p <br />Electrical Contractor Mail Address City State/Zip Phone <br />r'A��ios�d3�� 3 <br />State License Number <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />� Zs !?- d0 <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description ofWorkto Be Done: /�5�i� G�r .5��`Gf� �Q�� /L(ywpr'�j'FQ �'fG//GQ/A(� f�`/� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that 1 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 c nstr tionf, That 1 am authorized by the owner of this property to perform the <br />work for which pli �ion �s made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. � � � <br />'' r <br />� <br />Date <br />REVISED 3/20/13 <br />FEE <br />"J � �'��', <br />_� <br />PERMIT# <br />EI���-o�z <br />