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•r <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> w. <br /> 425-257-8810 - FAX 425-257-8857-wweverettwa.org <br /> >�V�i2�'Tr�PS ® �/E(�,�TIV�/f'r• GQY <br /> PROJECT ADDRESS <br /> ioo.BOX 3707 99/24-2207 -11z6 3- 22212 l <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mall Address City StatelZip Phone <br /> o�®�9���t�7��,>/�.ti ,B�x�ll0 7 1111f1 �fZ75 - Z�z9����5� <br /> Electrical Contractor Mall Address City State/Zip Phone <br /> o-170599 <br /> State License Number(required) City of Everett Business License Number(required) <br /> 4&1,52no <br /> Proposed Use of Building Contract PriceofWork ,J <br /> hl�i�lf7�iYJ/Y1�� �/�Gyi7: Ce <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 elf-)CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <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 E I f � _ C)�C, <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and 1t� I <br /> .r <br /> 296.200 WAC., <br /> gnature Date -- ----- - - -- --- ----- - ----- - - —. <br /> GENERAL CONSTRUCTION COMPANY <br /> REVISED oavrv2o+4 F.O.BOX 46-MUICLTEO,WA 98275 <br /> 425-294-6944-FAX-425-294-6947 <br />