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.gov <br /> 1121�1. lq-h^ �ve �� ��) � V-Pi1��i.� G2l/►�`�-�J <br /> �C1 ���1 J�P � �--' _.�_��'�_ _ <br /> PROJECT ADDRESS <br /> N V1� a �o � �e u�. Q�3Do� <br /> Owner Mail Address City State/Zip Phone <br /> � � <br /> Tenant ail ddress City State/Zip Phone <br /> , �as�o3 <br /> �ro C�.u,er ��.s /o�D�i la-o � N� �1�.��,�,k� oa��, <br /> Electrical ContraCtor Mail Address City �j��� State/Zip Phone <br /> o �--`��f�-5v 8 � �� ZI�51�1 <br /> State License Number(required) City of Everett B siness License Number(required) <br /> Proposed Use of Building Contract Price of Work � <br /> �1,�-�-h�r�{��kQ-- 6��R(� - <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: L.�� 1 �`�"�"�-- �� `S V w Q <br /> ��� ���� �a�� <br /> FEE _ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ��/�, D�� <br /> �, V� <br /> 1 hereby certrfy that I have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances goveming this type of wo�k wili be completed <br /> whether spe ied herein o�not. The granting of a permit does not presume fo give authority to PERMIT# <br /> violate or ca`n�I th,e provisions of any other state or local law regulating construction or the � • n <br /> perfo�mance of construction. That I am aufhorized by the owner of this property to perform the � ��(.� � D�� <br /> work for which application is made and 1 comply with the State Contractors Law 18.2/7 RCW and V �� <br /> 296.200 tNAC. . f , , <br /> �� � ���/''r�t ' � '���f7\� � � <br /> :�, . t� `- ,�'.�� i � � . �� , �",�'��,>>��- <br /> Signature ' Date , <br /> REVISED 08/Ofi2074 <br />