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r <br /> Y 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 /> 1/E2�"iT o e 5 ® E�1lER -rf�n/,4. (30V <br /> PROJECT ADDRESS <br /> 62X 37070> ,&)4 99/2 122,07 --1-z6- 3�12-2/2 J <br /> Owner Mail Address City State/Zip Phone <br /> p <br /> r• <br /> Tenant Mall Address City State/Zip Phone <br /> Electrical Contractor Mall Address City State/Zip Phone <br /> 0�`a5 99 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: <br /> FEE�, 2 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 �o� <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 f <br /> performance of construction. That 1 am authorized by the owner of this property to perform the l ` l <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC.., <br /> -tea- l <br /> gnature <br /> Date <br /> GENERAL CONSTRUCTION COMPANY <br /> REVISED 0W612014 P.0.BOX 46-MLWLTEO,WA 96275 <br /> 425-294-66944-FAX-425-294-6947 <br />