Laserfiche WebLink
ELf CTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVlCES 5`�—i 3 <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8557 — www.everettwa.org � �� s-L�5 <br />PROJECT ADDRESS <br />L <br />Tenant <br />� <br />Elecirical C <br />J �J,, o /�� W= <br />MailAddre s <br />Mail Atldress <br />� L,('r� �C ���'1'JJ <br />Idail Address <br />�)%C `��� �/` �/D'J � �- <br />State License Number <br />��C-� ri�� (/�i/ , �� �` <br />Proposed se o( Building <br />Square Foolage Q( residential new construction, remodel or addilion) <br />Number of devices (If low vollaye) <br />Description of Work to Be Done: <br />� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />L <br />City <br />City <br />,�O <br />-1 <br />Cily <br />���f ��� y��o1� <br />State/Zip <br />State/Zip <br />SlalelZip <br />4�'Tx'� �'' <br />Contract Price of Work <br />Contact Person (Plan Review) <br />I heroby ceRily that I have read and examined tbis applicafion and know fhe same to be true and <br />correct. All provisions o(laws and ordinances goveming (his lype o/work will be completed <br />whefher specilied herein ornoL The granting o(a permit does not �vesume to give aufhonfy to <br />violale orcance/ the pravisions oI any otherstate orlocal la�v rogulating consfn�chon orthe <br />perfonnance olconsWction. Thaf 1 am aufhonzed by fhe o�vner ollhis prr.verty'o nerinnn the <br />work for which application is rnade and I cornpty �vilh the State ConVac(ors Law 1827 RCW and <br />296.200 WAC. <br />�"l� / k�i�i �aiC'"�./..,_ ,../ :', l/-/3 <br />i �:��-�;:::3:.�,3 <br />Phone <br />Phone <br />�� <br />Phone <br />� <br />FEE <br />�) �J �'' �/ <br />PEFMIT# <br />E I �'�G�. _C:O� <br />