Laserfiche WebLink
Feb 08 16 01:34p Garvin Enterprises Inc. 360-653-8534 p.2 <br /> 1U/19/2015 10:31 FAX 425 257 OF <br /> EVERETT PER1riIT SERVICES ia003/003 <br /> 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 /> f as5. ,e\0-N, -4- AVE., <br /> PROJECT ADDRESS <br /> ClYC\ok_r <br /> Owner Mail Address <br /> City State/Zip Phone <br /> Tenant Mat Address <br /> City State/Zip Phone <br /> (30)• <br /> �-�— ,•,,n �� � r: IA r . I :2:70 ,5. —1Y3s <br /> Electrical Contractor Mail Address City Stater <br /> -4a Phone <br /> • <br /> \,/ ET A i c 0391o : <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> • <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(Lf low voltage) <br /> Description of Work to Be Done: QY Yl � - Ivo rCtirv _ v k C <br /> J e � <br /> • <br /> FEE <br /> CITY OFEVERETT LOCAL SALES TAX CODE IS3105 <br /> 1 hereby certify that I have read end 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 riot 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 1 am authorized by the ownerof this property to perform the E 1 O�� o 1l <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> V`"� <br /> 296.200 VVRC. <br /> —(:)-"YYtA--/--dct51 n /Vs��---- Ci <br /> g ature t t <br /> • <br /> REVI Sea 02/0620id <br />