Laserfiche WebLink
ELECTRICAL PERMiI' APPLICATIOtV <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 />� � <br />` `� � �= �: l� ,� � /� S � . �L � ��� �;� 7— � � � � � ��:� ���' f <br />PROJECT ADDRESS <br />�. �/:;t>� `r�73 - <br />��>�� �-C, ���"/ /'"/i��/�- �°c� %�x ��zE;�� ���'/����i � �.���} - i���� � '���1 <br />OWner Mail Address City State/Zip Phone <br />C'� /� � �� y�=' i <br />Tenant <br />L �L�� 2i�' ���. <br />Electrical Contractor <br />State License Number (required) <br />Mail Address <br />Mail Address <br />�� � C:-L � �� ��,� , z �; <br />Proposed Use of Building <br />Square Footage (If residential new construction, rem� del or addition) <br />Number of devices (If low voltage) <br />City <br />City <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />Cify of Everett Business License Number (required) <br />� <br />-� 7� a , �^� C9 <br />Contract Price of Work <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: ��- i..�.,P /� S� ��C' l� �-- ��' �S -� <br />SL.�'C �� � � C..-� S�� � X � S' % � :�; C•� %�,���3 Cic� /Z- �,4�%�- � ,�il,i7/�r�,ti C � <br />/�r' �+G� �/7 /i/ f sa�i�'v � �` f�i �Ll % lJ i� i � � �S ,��/,�'/� f j�UQ ����7 / �� <br />� C t:i�-'� ., <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify thaf ! have read and examined this application and know fhe same to be true and <br />correct. All provisions of laws and ordinances governing this type of worl< will be completed <br />whether specified herein or not. The granting of a permif does not presume to give authoriiy fo <br />violate or cancel the provisions of any other state or local law regulating construcfion or fhe <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />work for which application is rnade and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />r-- <br />./� � � �„ �U � % % - � S <br />5ignature Date <br />REVISED 08/06/2014 <br />FEE <br />�,�- �-y <br />� � <br />, ,� <br />PERMIT# <br />E � � ��'�; ;'�. �� ��- <br />