Laserfiche WebLink
Dec. 21. 2015 10:35�'- <br />0 No.1281 P. 2 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 93201 <br />425-257-8310 - FAX 425-257-8857 — wvnv everettv✓a.org <br />C I SlZ -la � <br />A-7s s e'u� <br />PROJECT ADDRESS <br />LLY�,ti�� 1,�.��iK-r�c.('c �(kt� t�,1Vi�e�: f)I�- �,��•��- ���ii>>=> �tZ,-n��l� <br />Ovate Mail Address City 51a1nJZip Phone <br />Tenant <br />Mail AddreSS <br />City StateLp Phone <br />��1i� <br />b A15 1-41of A.tom A5� <br />f-"q('cl <br />Electrical Contractor -- <br />Mall Address <br />City state/zip Phone <br />6.6Af \ <br />State License Number (required) <br />Proposed (Use orrf,�Building <br />I [VU <br />Square Footage (It residential new Construction, remodel or addition) <br />0(11(0K— <br />. City of Everett Business License Number (required) <br />?W) <br />Contract Pnce or work <br />'I YI ?a <br />111��" <br />Contact Person/ContaCt Number/Email <br />Number of devices (It low voltage) <br />Description of Work to Be Done (ALL �/1 ��`n.Le� <br />CITY OF E-VERETT LOCAL SALES TAX CODE IS 3105 <br />I nereby ce6ty that I have read and examined this application and know. the same to be (rue 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 no: presume to give authority to <br />violate or cancel the provisions of any other stale or local law regulating construction or the <br />pcdom,ance of construction That I am authorized by the owner of this properly 10 perform the <br />work for which y plrcation is made and I comply with the State Contractors Law 19.27 RC W and <br />296. 200 WKV , <br />Signature •- — ste <br />PGOSEbOW4701.1 <br />E ��-0 <br />rPERh1iT. <br />EIIJ�2��`7� <br />