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 - v,nvw.everetb�,a.org <br />� i� 4 (-i � GI �f w�w .1d 4� Si'7 n 2 <br />��— ! r tR c.�-t k l �. - •.� <br />PROJECT ADDRESS <br />CL�tt1 1tto�rb4cC�er (oIQ'9 �e�..�,._c.�'S�. ��-e:e�i� <br />O�•mer Mail Address Ciry <br />Tenani <br />Matl Address <br />CRy <br />6 �5ia--o'?l <br />, .,_Gi--/S� <br />� V / <br />kl tfi <br />St3le/Zip <br />Sl�te/Zip <br />q 8Z o 3 <br />Fl me <br />Phone <br />�V� �e�fri`t I�, e. Z 430Z 61IAu�t.S, 14�,b�,r�, �,J c�f S PQoI zf�S341�TTZ <br />EleCtrieal COntraClor Mad Address City State2ip Phone <br />�qYE�E(-� BSICi� <br />Siate License Number (reo.uired) <br />Propased Use o( Buitding <br />Square Footage QI residenlial new conslruction, remodel or addiUon) <br />h'umber o( devices pf low voltage) <br />City of Everett Business License Number (required) <br />6a d Q <br />Coniracl Price of Work <br />Contact PersoniContact NuinbedEmail <br />Desciiption of Work to Be Done: {� ��-"�Q-1%O �� �"� C S y��t i"` �_'""' '� � �'�i �� <br />C1TY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I herr.by ceRily Ihat l have read and exarrrined fhis applicatinn and know fhe same (o be tnie and <br />r,ormc(. All provisions ollows �md ordinanccs yovemin9 this fype ol u•o�k will be complefed <br />�vhether specified he�cin oi noL The r�ranlin� ol a penni( docs not presume fo givc au(hority lo <br />violate or cancel Uie provisions olany other state or focal law regul�fing consWclion or (he <br />peAomiance ol consfn�c(ion. Thal 1 am aufhom_eU by (he ormer ollhis property to perfomi the <br />�vork Ior �vhicb application is madc and I comply nifh Ihc Sfa(e Contr�clo�s La�v 18.2% RCW and <br />296.200 WAC. , <br />CiVr <br />qEVISE000r1°i7��� <br />r�( 4 ( r � <br />FEE I� b �° <br />PERMIT# <br />E i�ji�v 0`7 � <br />