Laserfiche WebLink
ELECTRICAL PERMIT APPILICATION <br />CITY OF EVERETT PERMIT �ERVIGES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.evereriwa.org <br />�iE,O ! ��L.�EG;E�.E� W+`�Y <br />PROJEC7 ADURESS <br />Owner <br />G�, <br />Tenant <br />Eleclrical Contractor <br />�nr,l `1(0 0 I Lrv�e,ra <br />Matl Address <br />yt GI <br />Mail Address C�ly <br />Mail Address <br />� �-oT� ►pr��38'P <br />State License Number (required) <br />Proposed Use of Building <br />S- <br />City <br />Square Footage (If residential new construclion, remodel or addition) <br />Number of ilevices (if low voltage) <br />Descnption of Work to Be Done: �lX�� <br />CITY OF EVERE7T LOCAL SALES TAX CODE IS 3105 <br />� <br />l2 -�1-� fG <br />C ►4�z-vo� <br />Stale/Zip <br />Stale/Zip <br />Phanc <br />Phonc <br />2S'3 <br />Phone <br />3��u3 <br />City of Everetl Business License Number (required) <br />_ y�o . �. <br />Cont2ct Pnce of Work <br />Contact Person/Contact Number/Email <br />1 hereby cedily fhaf 1 have iead and examined lhis applicafion and know the same (o be frue and <br />correc[ All provisions o//aws and ordinances goveming (his fype ol woik will be completed <br />whe(her speci(ed herein or nof. The grenfing ol a permit does nof presvme to give authonty to <br />violafe orcancel!he pmvisions o/any ofher sfate orlocaf law regulating consbudion o; fhe <br />peAoimance ol n �rt�r.fion. That I am aulhonzed bylhe owner ol fhis property to pcAoi;�t lhe <br />work lor which ppG ation is radr• and 1 cromply wilh fhe Sfale Confradors Law 18.27 RCW' and <br />296200 WA . / <br />REV6CDOBNNlor� <br />FEE <br />�l0' 1 � <br />PERMIT1t <br />E ( `�Iz-00� <br />