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T <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 /> �1IE�2�"T7`�PS ® �E�.E r-rin/�1-. GQV <br /> PROJECT ADDRESS <br /> 70 / /�j <br /> 7 60f�XCJ �i/ 9 F1241-G Zo/-7 /L✓f 3/! 2/2 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address city State/Zip Phone <br /> Electrical Contractor Mail Address city State2lp Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Aoki.Him1y2F-6 <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 /> 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 <br /> performance of construction. That 1 am authorized by the owner of this property to perform the /L <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC., <br /> gnature Date <br /> GENERAL CONSTRUCTION COMPANY <br /> REVISED OW6)2014 P.O.BOX 46-MMLTEO,WA 98275 _ <br /> 425-294-6944-FAX-425-294-6947 <br />