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 -- www.evc:rettwa.org <br />PROJECT ADDRESS <br />G� <br />Owner <br />Tenant <br />Mail AdOress <br />Mail Address <br />Mail Address <br />Sh�F �Ns -ar ��e Dt3 <br />State License Number (required) <br />Proposed Use of Building <br />Square Footage (If residenlial new construclion, remodel or addition) <br />Number o( devices (If luw vollage) <br />City Stale2ip <br />? Eli/�P�T �A/.� <br />City <br />City <br />Phone <br />SlatelZip Phone <br />. �i A / 1� u 2aF �,2q .Za <br />SlalelZip <br />Phone <br />�'i,3Gs2 05 <br />City of Everett Business License Number (required) <br />/ Q� �hor1�? �G� 3�ti7ozo <br />Conlract Price ot Work <br />�v/�� <br />Contact PersonlContact NumbedEmail <br />Descriplion of Work to Be Done: /i2 pD Q'�(/ dC��`�{T rG'� F�i�� /��'e'�� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily fhat I have read and examined this applicalion and know the same to be frue and <br />correct. All provisions o/laws and ordinances goveming this type ol work will be completed <br />whether specilied herein or not. The granfing o( a permif does not presume fo give authority to <br />violate arcancel fhe provisions o(any ofherstafe or local law reg�lafing tonstrucfion or the <br />peAormance of consfrucfion. That 1 am authorized by the owner ol fhis propeRy to peAorm the <br />work (or which applicafion is made and 1 comply with the State Confrectors Law 98.27 RCW and <br />296.200 WAC. <br />—�!!� '— �5_� <br />aeviseo oeAami� <br />FEE <br />�7-5D <br />PERMIT# <br />E 150(-1Z�o <br />