Laserfiche WebLink
� <br />ELEC ICAL PERIltIIT APPLICATION <br />CITY �F EVERETT PERMIT SERVICES <br />32Q0 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 42�-257-8857 — �.f c-�� �,��%-�';�t-�%�.;"tl= ��;� - ;7�� ;�' <br />.c ' <br />t° {•La('.�r , . .�'✓�P L/`�' r � �J `J' � tL''t�4�i'2:'_�7'�' �A�K.. .'�� ,� 'i� �� <br />�: <br />PROJECT ADDRESS <br />t � t�1 <br />Owner <br />Tenant <br />'t' � i �. »�� <br />a� a�� z;�� � h'.- �? <br />Mail Address <br />�, � . <br />Mail Address <br />� �{�G�� <br />City <br />City <br />�,.�q'� cf �' �- �' � <br />State/Zip <br />StatelZip <br />Phone <br />Phone <br />tr��r��?U�t,��;? �,i-�'tt?i(f {'a �;�X ��r.� ��; ���,/ � L..,� i- �; �/ , )'j ) <br />� f i /--i%I�iJ� �1. �� �r)V {i'� � � � % � � �'LL. �(,1 { (/ <br />Electrical Contractar Mail Address City 5tate/Zip Phone <br />;r�, � . � <br />R - ,:��.,�� � :���� �.�� ��u�� <br />State License Number (required) City of Everett Business License Number (required) <br />t���Ji-%��z.�;t`� l'�.`� `� � `�' , t°' �... <br />e <br />Proposed Use of Building Contract Price of Work <br />Square Footage (If residential new construction, remodel or addition) <br />� <br />Number of devices (If low voltage) <br />`T .1 C-?-v�+� �� r3 -r-s �� - rw ��� �r,. �i. ,-., � L; N� ; �;� <br />Contact Person/C�ntact Number/Email <br />Description of Work to Be Done: C��Sf1����i�iL-/ L��'t���,'�° 5-'�v i N� i�;r�"�;:���yi��7'w�— 4}= � tUrl� � i <br />'� ri'TL-� d=,'� J.t � l f aF� ti i� l•' �-`L � S .€" <br />CITY OF EVERETT LOCAL SALES TAX CODE !S 3105 <br />l hereby certify that ! have read and examfned fhis application and know the same to be true and <br />correct. Rll provisions of laws and ordinances governing this type of work will be complefed <br />whether specified herern or not. The granting of a permif does nof presume to give authority to <br />violate or cance/ the provisions of any other sfate orlocal law regulating const�uction or the <br />performance of constructron. Thaf / am authorized by the owner of this property fo perform fhe <br />work for which applicatron is made and ! comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />gna <br />uate <br />REVISED 08/06/20i4 � �' � � -�-jl f,� /� h <br />r �� Q�- 4 y""j <br />FEE <br />�3�-��c!% <br />PERMIT# <br />E��Ic�—�G� <br />