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.everettwa.org <br /> 1-0 -cam 1Z ✓� O <br /> PROJECT ADDRESS ��Jw7b �,�/ <br /> 11C-Ii//14 � , c=� r4 -7( it/X/2151/AI `-14- 7"&7;76, <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> • <br /> --Law r ,0 L-71yy <br /> Electrical Contractor Mail Add(ess City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: OV17 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 C <br /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the E y)U I J� <br /> work for which plication is made and I comply with the State Contractors Law 18.27 RCW and _ / / 0- <br /> 296.200 <br /> Signature Date <br /> REVISED 08/06/2014 <br />