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_ � 2 <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 7 <br /> PROJECT ADDRESS <br /> ,62Ei.�Y /o eeX 3 707 Av4 g 81241-2 207 <br /> Owner Mall Address Clty State/Zlp Phone <br /> ` Tenant Mall Address City Statel2ip Phone <br /> Electrical Contractor Mail Address City StatelZip Phone <br /> � �c%ecc 9 s::�oz_ oho 9� <br /> State License Number(required) City olsveretl Business License Number(required) <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 goveming 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 o,`construction. That I am authorized by the owner of this property to perform the E <br /> work for which application is made and I comply with the State Contractors Law 16.27 RCW and <br /> 296.200 WAC,,, <br /> gnature Date� <br /> REVISED 0R/0&7074i GENERAL CONSTRUCTION COMPANY <br /> P.O.BOX 46-MUKrLTEO,WA 98275 <br /> 425-294-6944-FAX-425-29"947 <br /> T/T:aFUd L988L9Z9Z'v6:01 :uto.i3 9E LT 9TOZ-OE-AON <br />