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• • <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 /> 8012 Florida Dr Everett, WA 98203 <br /> PROJECT ADDRESS <br /> Joan Manley 5622 Beverley Ln Everett WA 98203 425-308-6393 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Andgar Corporation PO Box 2708 Ferndale WA 360-366-9900 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> ANDGAC*011L5 $1000.00 <br /> State License Number Contract Price of Work <br /> single family dwelling Dale Van Rooyen <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> 1 <br /> Number of devices (If low voltage) <br /> Description of work to Be Done: Replace Furnace - Like In Kind <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 q—S <br /> I 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 <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and ` <br /> 296.200 WAC. <br /> Marla J RaSke Digitally signed by <br /> Marla J Raske <br /> Signature Date <br /> REVISED 3/20/13 <br />