Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> # 3200 CEDAR STREET, EVERETT, WA 98201 <br /> I 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> & 4107 <br /> PROJECT ADDRESS <br /> s�:Gc�, x:�a [��c, �14-19 r�jrt-r /.►�tC� S� �y�,r�--f� (.�,�r ����.-�� f�-Z� <br /> Owner Mail Address City State/Zip Phone <br /> Tenan/t� 51q ,J/ Mail Address City State/Zip Phone <br /> Elec ical C(AtractoK Mail Address Ci(y State/ZipPhone <br /> /��� <br /> rJU z <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: —T'l fry I V '� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br /> I 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 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 E140 ' — <br /> work <br /> 140 ' --work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signa Date <br /> REVISED 3/10113 <br />