Laserfiche WebLink
Ih � �-' � H-r � � � �' �..�_ !z � r`� � �i 4 � ,R, �i, � � � � �� � ° .`; �� i <br />_._ - � -� e <br />� , , , ,� .; � t�ti � , , �� <br />� - <br />�I�� �F ������� ����f� ����I��� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� ��� � <br />PROJECT ADDRESS <br />�— <br />Owner <br />Tenant <br />�C �',L� L [E c <br />Electrical Contractor <br />=� � L' <br />Mai Address <br />Mail Address <br />' �-$� <br />Mail Address <br />�P�C-'LC= C= /C� Cy � f <br />State License Number (requir ) <br />�T��2C� <br />City <br />City <br />-�f�,�; G� L�'�� v%3 <br />City <br />,D���F��-��,�� �G�'�,�1 �` �'�� <br />Proposed Use of Buiiding <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />Phone <br />City of Everett Business License Number (required) <br />�o?, c��� �� <br />Contract Price of Work <br />� ;��- ��� ��- ��/ <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: ���_�' w` C��tC� � U`Cy-�=�i�-` �' v "/�7�'���%�� <br />��4,�'�'i � ` �� � l.e �� �GJ � ���'vS � .L��/l�E�' <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that l have read and examined this application and know the same to be true and <br />correct. Al1 provisions of laws and ordinances goveming this fype 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 cance! the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this properfy to perform the <br />work for which application is made and 1 comply with the Sfate Contractors Law 18.27 RCW and <br />296.200 WAC. � <br />REVISED 08/06/2014 <br />FEE <br />-`� t/�-" <br />� <br />t" <br />PERMIT# <br />�'�������� <br />