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 />� 3 �\ C�, ��v t� vC- <br />PROJECT ADDRESS <br />K��11 �eJ l� �'+ 1...�--A i�� y� �� 3�- f��7�i1 <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />�CI <br />Electrical <br />Mail Address <br />�'t �Z L e c� c N �. <br />Mail Address <br />M �c, ��� c<�� c� ��v :� <br />State License Number (required) <br />S�� <br />Proposed Use of Building <br />1h <br />� / � , <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />C ity <br />���s s <br />C ity <br />State/Zip Phone <br />�f .� S � 3 �.' `l� �c� —I' <br />,� S� ���a 4���1 <br />State/Zip <br />Phone <br />� 3 �,' � `t Cv <br />City of Everett Business License Number (required) <br />Contract Price of Work <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: (�i= v-� ����- I�-- i l L.i-t C= ') ��� t���=- <br />�J ivt..� NC�;J t'��.1 JLVL I�G�.t�%� j� `� ��:;=, c���,�( �`�� :� t"� <br />� <br />j c� - f-��`.�:i :��"L. �0�--\ �\Ulc V�\ � <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � I� r`� �� <br />l v <br />1 hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances goveming this type of work will be completed <br />whefher specified herein or nof. The granting of a permit does not presume to give authority io PERMIT# <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That 1 am authonzed by the owner of this properfy to perform the E I��1 �• I(�� <br />work for which application is made and I comply with the Sfate Confractors Law 18.27 RCW and 1�� <br />296.200 WAC. <br />�% _ �� _ <br />Date <br />REVI SED 08/06/2014 <br />