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3617 GEYER LN 2016-09-28
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3617 GEYER LN 2016-09-28
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Last modified
9/28/2016 1:36:51 PM
Creation date
9/28/2016 1:36:35 PM
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Address Document
Street Name
GEYER LN
Street Number
3617
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F� <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.gov <br /> 3(o\-1 &e sAer gg x.03 <br /> PROJECT ADDRESS <br /> S-'re Q ,e,• 3(01'1 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> R�01Z yZS-3Z�,-�i3 <br /> t\ecArCQ\ rlo►\� CCcOL WA gsall <br /> Electrical ContraGL& Mail Address City State/Zip Phone <br /> (3wb+neSs- EL Qv at-McS 4 <br /> 1. X..q _ c,� <br /> Lam\- 5`1� 7/ <br /> State License Number(required) City of Everett Business License Number(required) <br /> 2e.S %% 6en+,C, -S -1 %-1O(0 .CO <br /> Proposed Use of Building_ Contract Price of Work <br /> CLA 25*) 32-Z- C�3(o L-1 <br /> Square Footage (If resid ntial new construction, remodel or addition) Contact Person/Contact Number/Email <br /> V - C'\ecA4 ZA <br /> Number of devices (If low voltage) <br /> S crv,c� .co <br /> Description of Work to Be Done: t +Z-t/j(9— <br /> e�-ti2�J t�� C C�C( 5 t•�� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 COO <br /> l hereby certify that 1 have read and examined this application and know the same to be true and DLJ <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 5� 00performance of construction. That/am authorized by the owner of this property to perform the <br /> EVV I work for which application is de and l comply with the State Contractors Law 18.27 RCW and <br /> 296.20 <br /> Ignature Date <br /> REVISED 08/06/2014 <br />
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