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 />✓ yl �/ �i c•z K.�. � �e � � � U c�( � <br />PROJECT ADDRESS <br />�-- <br />/ �l �� <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />d1W�D � (�� <br />City <br />City <br />State/Zip <br />State/Zip <br />:��� � ��Il � ll <br />Phone <br />Phone <br />� <br />��Z�G���< <J,%�� � :�<�� �� � �%s�� r�Qu,�,.�� I�,��� � � � �� y 3 �iz�� aio <br />Electrical Contractor Mail Address City State/Zip Phone <br />%��r��iu�� ( � �l GW <br />State License Number <br />Proposed Use of Building <br />� r�" � �� <br />Square Footage (If residential new construction, remodel or addition) <br />Number o devices (If low voltage) <br />����. �� <br />Contra t Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: �"eu� 2CL' y}� ��rv ��`"e � l/U �l �� �(� u�� �,��I,(��Q J <br />� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <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 governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authorify to <br />violate or cancel the provisions of any other state or local law regulating construction or fhe <br />performance of construction. That I am authorized by the owner of fhis 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. �7 _ — <br />Date <br />REVISED 3/20/13 <br />FEE <br />QG� <br />PERMIT# <br />Ei3(�--U�� <br />� <br />