Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425�57-8857 —www.everethva.org /Z -- � �� <br /> ; lU/ Z —O�ll <br /> � 7� `/ i',�NAUiCw � GU� <br /> PROJECT ADDRESS <br /> �� -r2 ��1� c�N ,� � �L <br /> Owner A1ailAddress C�ly Stale.Zp Phone <br /> � � �y P�a-�vAv � �w �>� u� E ✓El�F7T w �-�gz��3 3ss s2� 3 <br /> Tenant h9adAddress Ciry State2�p Phone <br /> � c� NC 1� <br /> Eiectrical Coniraclor Mail Atldress Clry SlatelZip Phone <br /> Slate I.icense Number(required) City ol Everett Business License Number(required) <br /> �'`t''d <br /> Proposed Use of Building CoNracl Price of Work <br /> y7e�.s , �tiN c l.�@ �'�'�c2c�iv�.= <br /> Squaie Footage pf residenlial new construction, remodel or addition) Contact PersoNContact NumbedEmail <br /> Number ol devices (I(low voltage) <br /> Oescriplion of Work�o Be Done: �- NS7�"L-L �Ow�=Q— � UTGC / /N � � R r � e A e E <br /> FoR- ��es � �vSrIL j c�AVU , <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 5�� <br /> i <br /> 1 hr.reby certily that 1 have rcad and examined fhis applica(ion and know the same fo be Irue and <br /> correcL All piovisions o/laws and ordinances goveming fhis type o/�vork will be complefed <br /> whetherspecified herein or noL The gnnfing ol a pemiif does no(pmsume(o give aufhonty fo PERMITr <br /> violale or cmicel the provisions ol any othersfate orlocal;atv regulating consWction or the f I ' r <br /> pedonnance ol consWcfion. That I am aufbonzed 6y(he ownerol(his propeRy to perfonn the E I �-{ I � — O �-1 <br /> �vork for which applicafion is made and 1 comply wilh the Slafe Contiacfors Law 18.27 RCW and � � <br /> 296200 WAC. <br /> ��'l,� � (�r�'�RK� (� �G �� / <br /> O <br /> Signalure Datc <br /> HEVISEOOS9G:ON <br />