Laserfiche WebLink
06!'0212015 21 : 33 96811 P. 001/002 <br /> qW <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 /> /6 S/1z /�A 44 7 - L 089Y I'M <br /> PROJECT ADDRESS y2 f <br /> Owner Mail Address city State/zip Phone <br /> Tenant Mail Address City / State/zip / h rhe <br /> EPLA 1jPV D-j- -- ,Pl� <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> f Ll Aklf lYzLP 6/6-'3l 7 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Numbar/Email <br /> Number of devices(If low voltage) <br /> [Description of Work to Be Done' Qfi{-Ll��/ � 'l~ Com/ <br /> FEE r— <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 2 D <br /> /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 gaveming 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 PERMIT# <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 the E <br /> work for which ap anon is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> nature ate <br /> - REVISED P8Ofi:014 <br />