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1O2 12 5 QRZ, <br /> a 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 /> �yEP-L'-` 7 PS ® ieVEReTrW1'}• COV <br /> J2��=L <br /> -// <br /> PROJECT ADDRESS CT <br /> 6 , t 9,F12-11- <br /> / 7 L,/ <br /> 26 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> ?�&X-�l0 7 (g6 , �Qf} Z7525 z9� 9s� <br /> � <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> S-�Ioz 005 99 <br /> State License Number(required) City of Everett Business License Number(required) <br /> /'�,000 <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 , <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> /hereby certify that 1 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 <br /> performance of construction. That I am authorized by the owner of this property to perform the t O I rn <br /> work for which application is made and l comply with the State Contractors Law 18.27 RCW and 6 lV <br /> 296.200 WAC., <br /> dam- - -1 <br /> gnature Date <br /> GENERAL CONSTRUCTION COMPANY <br /> P.O.BOX 46-MUKfLTEO,WA 98275 <br /> REVISED 08/O6/2074 ie7 171 425-294-6944-FAX-425-294-6947 <br />