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.org <br /> L.Vsyi 1�1rh�IN� Iltrr,,� <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> >a�/ H IATIQ17,4 /-i q,rafh-E Vied t✓ 7r <br /> Tenant Mail Address City State/Zip Phone <br /> NAL EL.EtTOUC- -S4D� MJ00d,&ALL Avg Eu,:,&w- " 9KJoi Lj.7rsaya-1��� <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> OM4LECI r1ILd8 0 2) -7 Q ILI <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> STaUEhtS .altD `l.(ol-DSII <br /> dSkGVLMS��I LII e-cty C6✓v� <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: o G--u r:z-- - <br /> r� Ljb- 1- 51-1 rc <br /> &tL TL IE i 5 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I 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 PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the I �� i <br /> performance of construction. That 1 am authorized by the owner of this property to perform the t I <br /> work for which application is made and l comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. 11. <br /> ALI— <br /> Signature Date <br /> REVISED 08/06,2014 <br />