Laserfiche WebLink
Buyer Electric Co 2063674575 p.1 <br /> M <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 /> 3 \2-- .--IiS c<'-'\. <br /> ROJECT ADDRESS <br /> aise-v V1 2- <br /> 3 --1 Ste t G 1 S- �3-1 <br /> r - Mail Address City Stale/Zip Phone <br /> 'enant Mail Address <br /> City Stake/Zip Phone <br /> El 'tractor <br /> Mail Address City State/Zip Phone <br /> eK a 022 `9 <br /> City of Eve Business License Number(required) <br /> State License Number(required) e7s) <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction,remodel or addition) Contact Person/ act Number/Email <br /> Number of devices(If low voltage) ���� <br /> c:CRRCW\--Ce> <br /> Description of Work to Be Done: _ ^^ ..4v 14� ' <br /> FEE 0 0 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 50 <br /> I hereby certify that 1 have read and examined this application and know the same to be true and <br /> correct. Al!provisions of lawsjnd 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 I am authorized by the owner of this property to perform the <br /> E (5 0 (work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 W C. <br /> . ,: rozilk,r) 1,,-- QcJZ' acS1.-71wtoqrz-v- ) <br /> -,,r‘. <br /> Signature Date •\ eCAQrW4Dik <br /> \****4V-kri—Ca‘6 1 ii <br /> REViSEO 08/06/2014 <br />