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729 100TH ST SE WA STATE LABOR AND INDUSTRIES 2019-08-15
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729 100TH ST SE WA STATE LABOR AND INDUSTRIES 2019-08-15
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Last modified
8/15/2019 11:26:12 AM
Creation date
4/6/2018 8:01:04 AM
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Template:
Address Document
Street Name
100TH ST SE
Street Number
729
Tenant Name
WA STATE LABOR AND INDUSTRIES
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� � � � �I � � � i ` �- <br />t t,, <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov ( www.everettwa.gov/permits <br />AGREEMENT: T hereby certify that / have iead and examined this appl�cation and know the same to be true and cor�ect. All provisions ot laws and ordinances goverrnng thrs <br />rype of work wifl be completed whether specified herein or not. The granting o/a permrt does not presume to give authorRy to violate or cancel the provisions af any other state or <br />local law regulating construction or the performance ol constructron. That 1 am authorized by the owner of this property to perform ihe work for which application is made and I <br />comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br />�, � ' <br />,. <br />, . ;� ; <br />''�,,/;, i .� ��'r���i � � � <br />Owner/Authorized Agent Signature Date <br />Ciry of Everott Officia! Use Only <br />FEE <br />�I�t��) <br />l � <br />PERMIT # <br />E �' <br />°� ° �iC�, � a � I <br />(Revised 10i12/2015) <br />
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