Laserfiche WebLink
ELism UTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 426-257-881Q - FAX425-257-8857— <br /> I'm&I 4vdre44ep.5 Cg-de, tia, d <br /> PROJECT ADDRESS <br /> Y'll -a <br /> Owner Mail AddressCity State/Zip Phone <br /> - tzvrc, <br /> Tenant Mail Address City State/Zip Phone <br /> 12>) 22 Z' <br /> Electrical Contractor Mail Address City-- State/Zip Phone <br /> 10"b-cvk1'e- T- �0'6 Ue"I <br /> State License Number(required) <br /> City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> 47 G-WT.jZq JJ -rW ir-K. uAL 92- 11,W Lo,V.,14, <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: rAA-el-I&/t2'tXt'y 5-AV I t'j� <br /> -14 -aLz <br /> I" I, vital":' 1-1vAt i) <br /> L <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 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 PE7RMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the 1; 1 <br /> performance of construction. That/am authorized by the owner of this property to perform the E <br /> work for which application is made and I comply with the State Contractors Law 16.27 RCW and <br /> 296.200 WAC. <br /> SigSignaturerate <br /> REVISED 08/06/2014 7D i,f 1-tA <br />