Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
� � <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 />70 "� L g��� S i- I � ,�� � ��� ��r �"U ����7 �v�-� �jg' z�-? � <br />PROJECT ADDRESS <br />�zs <br />�-v �� � �"��=c.�� 70 � l ��'�yc�/rl � ��+ i� �2j U�- G��¢ �"�s'L o � `��s -- /� l <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />Mail Address <br />City <br />State/Zip Phone <br />� �-� � i� r/� ��_ �' �C, (� �� S �tr� i �/ �j`"r�v« � i���r= �r� �Ur�Li.c��'�`�;' Lci�� ��s� <br />, <br />Electricel ContraCtor Mail Address City State/Zip Phone <br />�1-f � (/lr��-.� � r(�C� � i�-� <br />State License Number (required) <br />� X�-��"� /,�'��' �-��t�t� <br />Proposed Use of Buiiding <br />� '�1�,��''� ��C� /'S`Z�l� <br />Square Footage (If residential new construction, remodel or addition) <br />� <br />Number of devices (If low voltage) <br />City of Everett Business License Number (required) <br />c>� <br />i�j��� �.5�� <br />Contract Price of Work <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: CL-J� �Ac_' /,(,�� �� �;%�' %�...�-�s�� ���%'�/ %�(/L����� <br />�G'� �'`� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that l have read and examined this application and know the same to be true and <br />correct. All provisions of (aws 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 <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance f construction. That I am authorized by the owner of this property to perform the <br />work for whic pplication is made and l comply with the State Contractors Law 18.27 RCW and <br />29�61200 WA .� <br />REV/SED 08/O6/2014 <br />FEE <br />�`�� UG <br />� / <br />PERMIT# <br />El�ll-�-`�� <br />