Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT. WA 96201 <br /> 425-257.8810 - FAX 425-257.8857-vivnv.everettwa.org <br /> 10 <br /> A _ + C 150 S <br /> st s c PROJECT ADDRESS <br /> Oxnet Mail Address Cry 5tateizip Phone <br /> Con•Qendi 1Nao soTM s-r SG, vrc rvuc +4 ulA Ux03 <br /> Tenant Mad Address Cay Statelzip Phone <br /> Pe;,nfer E1eC+f .rne. li i&dDr2J Sow W ?"A W- 151. 13" <br /> Electrical Contractor Man Address ca, 5talCZpp Phone <br /> POT/yTE= Ili _ d. 19 ? 7 <br /> State License Number(required) City of Everett Business License Number(required) <br /> T-4&4 <br /> Fir.-posed Lice c!Building CContract^Pnce of Work w -2�- <br /> �X ver '9771-9�4 <br /> Square Footage(II residential new construction,remodel or addition) Contact Person/Contact NumberiEmail <br /> Number of devices(If low voltage) <br /> �/►pA A,11 kri A A jq% <br /> r <br /> Description of Work to Be Done 0741 L� . 11'r I <br /> )AI M 1"Oln :V 40 L <br /> r'1r14N+.!�. <br /> FEE 2 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 l LL•7� <br /> 1 hereby certify that I have read and examined this apphcal,on 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 authonty to PERMiIT# / Q <br /> violate or cancel the provisions of any other state or local law regulating construction or the E l Jo 5 J Oda <br /> performance of construction. That I am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18 27 RCW and <br /> 296 200 WAC. <br /> Signature Date <br /> r+rwsrnosm;ui. <br />