Laserfiche WebLink
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 />� � 32� <br />v � "� <br />< <� �� ��.��� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />,i�i%i- <br />City <br />City <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />� <br />j,�"i ii�-i i Y G � �=�°�1, ��� � S�=�z� �� �.� s� .�P�r� s,� ,� � �%� �� ��0�.�' �'�� - �'7�- �92 <br />Electrical Contractor Mail Address City State/Zip Phone <br />�.,�%�i//1l� � �y�� <T,7 <br />State License Number <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />(j <br />/, • -G <br />�, iJy' G7 0!/' ��`�'��1� � <br />C�.� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />�Fl � ����'J <br />Contract Price of Work <br />Contact Person (Plan Review) <br />;���1-�' <br />1 hereby certify that I have read and examined this application and know the same to be true and <br />correct. Al1 provisions of laws and ordinances governing this fype of work will be completed <br />whether specifred 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 loca/ law regulating construction or the <br />performance of construction. That ! am authorized by the owner of fhis property to pertorm the <br />work for which appfication is made and I comply with the Sfate Contractors Law 18.27 RCW and <br />296.200 WAC. <br />GJ <br />REVISED 3/20/13 <br />re <br />,�, <br />FEE <br />� ��� <br />�� <br />PERMIT# <br />EW9311 - DOf <br />