Laserfiche WebLink
ELECTRICAL PEI�MIT APPLICATION <br />CITY OF EVERETT PEkMIT SEkVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />��� � �Pli{� �Iq�� �I;YA�� �Jl'.i'P � <br />PROJECT ADDRESS <br />Owner <br />H'V-R (��ock `i�o <br />Tenant <br />Electrical <br />�I=Mt1C F,1�i5 3G� �' <br />Slate License Number <br />�- av�,e c;c�� r ('�a� � <br />Proposed Use of Building <br />Po . .fJi <br />Mail Atldress <br />Mail Address <br />Mail Atldress <br />Ci�y <br />° C-�,eh <br />Cily <br />K, rkl� <br />City <br />Squam Footage (If residential new construction, remodel or addition) <br />I <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Slate2ip Phone <br />SlatelZip <br />' /9hC> <br />StatelZip <br />i o� <br />Contract Price of Work <br />Contact Person (Plan Review) <br />I hereby certily Ihat I havc read and exantined Ihis application and kno�v the samc fo be I�ue and <br />conect. All provisions o( laws and ordinanr.es goveming fhis type of �vork �vdl be complefed <br />whether speci(ed he�cin oi nat The �ranting ol a pr.nnit does not presumc (n give aulhonty (o <br />violafe orcancel the provisions n/any ofher stafe or local law re�ula�in[� consfmcfion or fhe <br />pedormance ol r.onsM�cfion. Thaf I arn aulhonzed by fhe owner o/ (his property (o pedortn Uie <br />work lor which application is made and 1 comply wifh (Oe Stale Contractors Law 7827 RC W and <br />296.200 WAC.. <br />� Lf-CCL`�7 ��/«.�Lc- ��-C��- �, <br />_, _ <br />Phone <br />Phone <br />FEE <br />�'lU` � <br />PERMIT# <br />E l3(0- �%� <br />