Laserfiche WebLink
� <br />�rC�(� <br />� � <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 />��� _...i � �� 2 �� � ��,��e �- �� � f � � ��$� �� <br />� F'I�� ��Jti:i " ADDRESS <br />:.1��� -��-..__.. <br />' le �n <br />_ ..0 ��.bl.��� �. <br />� IE: 'tC! :_ (.��ntr� <br />Mail Address <br />�� � � � <br />Mail Addt s <br />11 U �� Itil.�v'r, �� � <br />Mail Address <br />'' �t R- ��L�� �.1 � 1 '� t� <br />: 1�: : I .e: se Number (required) <br />' 7 ��, �� � � � 0 <br />_.� C� L�1 � �� � , � ►o � <br />� ���� :� i Jse of uilding �'�� <br />`.: c; . a�a I:.�tage (If residential new construction, remodel or addition) <br />` �. i �E � i devices (if low voltage) <br />a. c�i ;C r� of Work to Be Done: <br />City <br />City <br />r tC �� <br />City � <br />State/Zip <br />State/Zip <br />� �� <br />State/Zip <br />c�- <br />�2���- <br />Pho�e <br />I <br />i <br />I <br />Phone ' <br />� � � <br />�z��_ ��� <br />Phone <br />I, �����. <br />lJ _ <br />City of Everett Business License Number (requiredj <br />1'�, �,��� - <br />Contract Price of Work <br />C�1�CG�, <'��i��_CIti�,��/ <br />Contact Person/Contact Number/Email <br />y �� , � � l;� . �5 I 2 � <br />C�Ic�C�4ti�� � l���LC���►�C , CuY� <br />li (z) �(����- /,�Ul.a <br />FEE <br />: I" •f t��:i�lERETT LOCAL SALES TAX CODE IS 3105 �� DO <br />� h� �=f ,� � rtify that I have read and examined this application and know the same to be true and <br />_ oi �:c� . ! provisions of laws and ordinances governing this type of work will be completed <br />,��•� t`r •. � ecified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br />� 6:, i'�; ; ance/ the provisions of any other state or local law regulating construction or the ^ <br />c>e� : ii :: of construction. That I am authorized by the owner of this property to perfo�m the t ���� J, / ' <br />��o t;'i �� .�iic application is made and I comply with the State Contractors Law ? 8. 27 RCW and l <br /><"�?Ci' .CAC. <br />.ls_�� <br />ature <br />h���, rr o<-,�.e�2ota - <br />