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1015 MAPLE ST 2016-10-03
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1015 MAPLE ST 2016-10-03
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Last modified
10/3/2016 7:17:02 AM
Creation date
10/3/2016 7:17:01 AM
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Address Document
Street Name
MAPLE ST
Street Number
1015
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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 /> �yIS M r Si <br /> PROJECT ADDRESS <br /> pWA M5- 1500"— fo— Ab—NA P � t/� i �' 475 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> VPVlVC: ►'\ <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> .5 l l L <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) �n <br /> Description of Work to Be Done: `�� U�L— G Y� L---- L� f L- �SCA L l`AAl <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 -t 75 0/0 <br /> l hereby certify that I have read and examined this application and know the same to be true and `�J <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/am authorized by the owner of this property to perform the E <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAG -� <br /> lC�q <br /> Signature Date <br /> REVISED 08/06/2014 <br />
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