Laserfiche WebLink
• <br />ELECTRICAL PERMIT �4PPLI�ATIOIV <br />CITY OF EVERETT PERMIT �ERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� ���� �f ���� �s�-�� <br />PROJECT ADDRESS <br />�' .�-c' t 2�,ti /�i �� �l.v ��� S�v� <br />Ownef Mail Address City State/Zip Phone <br />S�-� �,...s� �:,�b �=5�).� � <br />Tenant ail Address <br />City <br />State/Zip <br />Phone <br />����� <br />�� �' i � k � � 1�..�� � _L,� c- �-Ci�z.- � : �i C�L � -} ����-�l � ��,�� �c �zz �l. <br />Electfical Contractor Mail Address City State/Zip Phone <br />f-�� � 1-<" �...�� z2 c'- �' <br />State License Number <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />�� <br />Number of devices (If low voltage) <br />5e c url"ttl <br />Description of Work to Be Done: i�L�,�.S �_l,� �\� � 5'VS �Q"�� <br />c � � i;�.� : <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />l�`�. �-�� v� <br />Contract rice of Work <br />Contact Person (Plan Review) <br />1 hereby certify that I have read and examined tl�is application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />wheiher spec�c�d herein or not. The granting of a permit does not presume to give authority to <br />violate or camce� the rovisions of any other staie orlocal law regulating construction or the <br />performance of �ons ruction. That I am authorized by the owner of this properiy to perfo�m the <br />work for which �ppli ation is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. " ,- ; <br />REVISED 3/20/13 <br />FEE <br />���u <br />PERMIT# <br />E��O� -� 2� <br />