Laserfiche WebLink
ELECTRICAL PERMIT APP L�CAT'10N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CLDAR STREET, L-VLRL IT, `.VA 98201 <br />425-257-8810 - FAX 425-257.8857 - www.everettwa org <br />PROJECT ADDRESS <br />Owner <br />Mad Address City <br />/iT' 11 <br />State/bp <br />Phone <br />doh-3� <br />Tenant <br />Mail Address City <br />StatelLp <br />Phone <br />Contractor Mad Address City StatelLp Phone <br />1M20'-7 Ec 3��yI1iC <br />Slate License Numb^r <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Num er of devices (if low voltage) <br />Description of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />,o� . � O ^UCH/ .O/� <br />Contract Price of Work <br />1pIL1Ja.4l Iy10011 <br />Contact Person (Plan Review <br />L)asa3i o30� <br />I hereby certify that 1 have read and examined this application and know the same to be hue 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 authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. Thal 1 am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Lew 18.27 RCW and <br />296.200 WAC. <br />FEE <br />(e D , <br />PERMrrrr <br />