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 />���� C,(�i��i'(\ ��J�. ,�V4 �I,� �.���� <br />PROJECT ADDRESS <br />°�� �rd�. <br />Tenant <br />Mail Address <br />Mail Address <br />City <br />City <br />� �( �`Zc� � �� � � ''J <br />State/Zip Phone <br />State/Zip Phone <br />��%��� <br />Electrical Contractor Mail Address City State/Zip Phone <br />State License Number (required) <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 />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City of Everett Business License Number (required) <br />Car�tract Price of Work <br />� �P i�1���,� I�r �� (�,lLh� l�. <br />ontact erson/Contact Number/Email <br />�� �-�-0 r �—�-$� <br />i�;. l,�al,�.� �� �mG�.� � � � c��n <br />, <br />1 hereby certify thaf I have read and examined this 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 />whefher 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 of consfruction. That 1 am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />ature <br />REVISED 08/06l2014 <br />FEE <br />��r�, <br />PERMIT# <br />E C� c��� � _ �'� ��� <br />