Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-'L57-8810 - FAX 425-257-8857 —www.everettwa.org <br /> �� �� � �"�'1����— �Y�� l..�- . <br /> PROJECTADDRESS ���F �,�-�-- <br /> Ownef Mail Address Cily State/Zip Phone <br /> Tenant Mail Address City Stale2ip /' , Phone <br /> �K�-S S� Z� � <br /> -r����� ��lEcd-��, e�� I �S�ru�c� s b�� , <br /> Electrical Conlrac�or MailAddress ( C �.Z/ � �y�City rs � /��.�St�Zfipe J� 41 S Phone <br /> > � L <br /> 'r:!�1kot)(�,CR S"ZCxC� _ �c7 <br /> Stale License Number Coniract Price of Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Square Footage Q(residential new construction, remodel or addition) <br /> Number of devices(If low vollage) <br /> Description o(Work to Be Done: ��� n�l��-` � ` ����'\�I-� T��d ���� <br /> � , <br /> � I �� C �� � <br /> � <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 / ��� <br /> I hereby certi(y that 1 have read and examined this application and know the same to 6e true and � <br /> conect All provisions o(laws and ordinances goveming this type o(work will be completed <br /> whe(her specilied herein or noL The gi�nting of a pennif does not presume to give authonty to PERMITr <br /> violate or cancel the provisions o(any otherstate orlocallaw regulating construction orthe � � <br /> perfo�mance /con Wction. That 1 am authonzed by lhe ownero/lhis property to per(orm the E I � l D— Z 7 — <br /> work l t c app calion is made and I con�oly with the State Contractors Law 18.27 RCW and <br /> 29G.200 <br /> r <br /> � n � � , --� <br /> � <br /> 1 v� i�nat ' Date <br /> � J <br /> REVISED 3R0/1�3 ' <br />