Laserfiche WebLink
ELECfZICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 — <br /> 4 <br /> e L/,�,re-44,e Ca—d e-vere-f--� wa-j 'Jj <br /> PROJECT ADDRESS <br /> D <br /> 0 <br /> Owner Mail Address city State/Zip Phone <br /> C,Ir <br /> Tenant Mail Address City State/Zip Phone <br /> 'A <br /> "v z' <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 <br /> .T- <br /> Square Footage (If residential new construction, remodel or addition) Ti-G-W ,Vn NContact Person/Contact Number/Email <br /> Number of devices (if low voltage) <br /> Description of Work to Be Done: C-LS i 1-f 1✓ <br /> -2- <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 C�af C) <br /> I hereby certify that/have read and examined this application and know the same to be true and <br /> correct. Ali 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/am authorized by the owner of this property to perform the E <br /> work for which application is made and/comply with the State Contractors Law 18.27 RCW and [VO <br /> 296.200 WAC. <br /> -�p'—fe Date <br /> Slglltll� 11 <br /> D <br /> REVISED 010612014 <br /> -T6 <br />