Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF I VERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982GI <br /> I 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> PROJECT ADDRESS q <br /> Owner Mail Address City SWOOP Pt3�ine i <br /> Tenant Mail Address city State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> eh G)L <br /> D OQ 169 U <br /> State License Number(required) City of Everett Business License Number(required) <br /> j <br /> Proposed Use of Building Contract Price of Work <br /> Square Tootage(If residential new construction,remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(tf low voltage) <br /> 1 <br /> Description f Work to Be Done: _ <br /> FEE <br /> CITY OF EVERETT LOCAL$ALES'TAX CODE IS 3105 � <br /> 1 hereby certify that 1 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 /> whetherspecified 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 no- ot <br /> performance of construction, That 1 am authorized by the owner of this property to perform the <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 9 :200 WAC. <br /> Signature Date <br /> REVISED 08I0640f4 <br />