Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> ,t 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> PROJECT ADDRESS <br /> t1/4'lrN- --s- GR5-ti - Z.22 • b s' S i CuES2E \ V.); - L125-350-512`\ <br /> Owner Mail Address City State/Zip Phone <br /> N N-1 <br /> Ten nt Mail Address City State/Zip Phone <br /> C511tr`l5,2_ 222 (QST 5i E VIA 125-3So$l <br /> Electrical Contractor Mail Address 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 J <br /> �20 3c,) c 11- ( -wmak-l\ C-�s"�\� \---to .) M t'Z4- "3 FSS-tLl.€/`,L l5 3 co-S b2st/ <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Mr.rw yt-90c1Aq-}to e <br /> 1. \.\:CoM <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: ,r(Z\i.a,- \' 1 Y E 2F--( c.o\r ' - \ .-"ii�t=wi -2.s2op. c)f,'-sEx__, <br /> '4-sp,pc,,Al.- NES 50c : 7/'wG, ,E ____ ,—) , u9 /\--;- _/ ( Pt.r\c_ . 'EXs.SkraiCg <br /> Cc€ D --c-v.F Cis).(1- 5 ---[\_ <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 415`Q <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 ne I0work for which application is made and l comply with the State Contractors Law 18.27 RCW and l u <br /> 296.200 WAC <br /> // <br /> / . - r' -''.%•' <br /> \0lt 3/►5 <br /> .*nature Date <br /> REVISED 08/06/2014 <br />