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 /> uc•t i J t.4-UJu T 3' <br /> PROJECT ADDRESS <br /> VA-Q 2ce t t vat-/.LCT tie Ze1'r-- LL :3 z-o <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> C18zi3 4zs- <br /> & 2- ' ,-rteLa-RA& ? )30n Z`e0 amaze_ c,t.)t� zsz-443( <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> P f <br /> le6,r'1 f Pte!ZS 3G/- <br /> State License Number (required) City of Everett Business License Number(required) <br /> iSIG/;//.G <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: * S6Zt,IIG0401;)L.0 0p/4" <br /> r ofL <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 75 00 <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 ^ ) (j-1 O (tea 1 ,'U�% <br /> performance of construction. That I am authorized by the owner of this property to perform the t o <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 6.41r4 /7 <br /> Signature 9.-Date <br /> REVISED 08/06/2014 <br />