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 /> PROJECT ADDRESS <br /> 8Ocf1) pMxz S a? ? 4 -erect 2 a r 98026:71 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Q 7 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> P4E/OA EL 3/0 Did =ce <br /> State License Number Contract Price of Work <br /> Proposed Use of uilding Contact Person (Plan Review) <br /> D500 Fr <br /> Square Footage (IT residential new construction, remodel or addition) <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: J\W T) i °Aida t_i4L --r J 1-107 u ATErr- 1IJ4.) ! % 746', <br /> tj ;/Etc- 1 CL isdlJ btp e 'rte 0_E 11 <br /> a L -A,( 7 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 q 0"U <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 l <br /> performance of construction. That I am authorized by the owner of this property to perform the EW L4 Q I_ 0(1)s <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �1- 4 ,(Jr`4. • <br /> � l l / <br /> i nature <br /> g ate <br /> REVISED 3/20/13 <br />