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ivz <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 /> E PS ® EVER -r�N�• GoV <br /> ba � <br /> PROJECT ADDRESS <br /> 1,0t9 46oX 37o7 a <br /> 4� �W g;?/2-1-2207 --1-,26- 3--12-21 z/ <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> 4, efM�AZ75 '�291/ <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> 1*1.H11m n Sea <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 f� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 "��` 00 <br /> I hereby certify that/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 r <br /> performance of construction. That/am authorized by the owner of this property to perform the t fl L VZ) <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> i <br /> gnalure Date <br /> GENERAL CONSTRUCTION COMPANY <br /> P.O.BOX 46-MUKILTEO,WA 98275 <br /> REVISED 0610612014f} G , 425-294-6944-FAX-425-294-6947 <br />