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• 0°3 7a— 57/ 7� <br /> ELECTRICAL PERMIT APP!CA s N <br /> CIN OF EVERETT PERMIT SERVICES <br /> • <br /> 3200 CEDAR STREET, EVERETT, WA 98201 qCY <br /> 425257-8810 - FAX 425-257-8857--www,everettwa.org <br /> 45-oi, D3 -ei/6-off C-,a <br /> -51 <br /> PROJECT ADDRESS l/ <br /> A RDx 37, 7 ' i Glib /2 c3,7� 7 -3 ; I,2/ <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City i Stafe/ P one <br /> v 25 294-69 <br /> Jyv_i4M)--44-/- ,7 <br /> Electrical Contractor Mail Address City State/Zie Phone <br /> • <br /> ev��cci° /() MoD <br /> • <br /> State License Number Contract Price of Work <br /> • • <br /> • <br /> • <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> • <br /> • <br /> Number of devices (If low voltage) <br /> • r <br /> Description of Work to Be Done: / L:C// / Z!/'1/4./ <br /> Jelad'e <br /> • <br /> • <br /> FEE ,VCITY OF EVERETT LOCAL SALES TAX CODE IS 3105 529 <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 PERMTT# <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 properly to perform the E <br /> work for which application is made and!comply with the State Contractors Law 18,27 ROW and `1 <br /> 296.200 WAC. '✓-' � ti 7 <br /> S nature Dote <br /> ee,ry GENERAL CONSTRUCTION COMPANY <br /> r +� P.O.BOX 46-MUKILTEO,WA 98275 <br /> P. :12 <br /> vrs=o 0120/10 477. 425-2946944-FAX-42 -294-6947 <br /> Efi:ar-ed LS88LSZSZT76:oZ :ntoj 55:00 DIo -£I JRfr <br />