Laserfiche WebLink
F.4* SQM r-r t <br /> w( . <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 /> Vic <br /> L 1D'4 A <br /> PROJECT ADDRESS <br /> ppovtMP.CZ <br /> fb 9P �r - - <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> //�� <br /> ipt.o CY SPA AVP- SL-;# 7 `�O(' <br /> ARs' <br /> C> '0Aa aukiTY C-1myp Soi"71Z 100 � U-1A c-F 0 _-1 ao-'l^3�iJ <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> ARaNsf-Lcz o i $5.-�Sr <br /> State License Number -Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(if residential new construction, remodel or addition) <br /> Number of devices(If low voltage) /� <br /> Description of Work to Be Done: TP�� t-ow VOL..r� SRCOfItr 5f5 SF-A~ � l0 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3905 * 15 60 <br /> 1 hereby certify that I have read and examined this application and know the same to be true and y <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 ' >� <br /> performance of construction, .That I am authorized by the owner of this property to perform the E5 <br /> work for'which application is made and I comply with the State Contractors Law 98.27 RGW and <br /> 296.2A WAC. <br /> Signature Date <br /> f A L AROP:50,a 0 AP<:iNStP515Cis P,C r,C:C"M pAx <br /> REVISED 3120113 <br />