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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 /> 3403 W CaS�nd • . ��I3o q--o l/ . <br /> If`-9--,3 <br /> é7h; (i /' 5- <br /> PROJECT ADDRESS <br /> • <br /> ,eE/rc/6. ,,BOX 3707 Llaefie Gr�,9 98/2 /....7,:2,7 1.25.3#2_212/ <br /> Mail Address • <br /> • Owner City State/Zip Phone <br /> Tenant Mail Address City. State Pone <br /> d-�/ . ' .�L.•, ._ .4.. - . . _!., l ,z 5 42529169 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> -6' oll & 9g4t, Z- 4/ 0200 <br /> State License Number Contract Prue of Work <br /> _Ith72 $ • <br /> Proposed Use of Building Contact Person (Plan Review) <br /> • <br /> Square Footage(If residential new construction,remodel or addition) <br /> • <br /> Number of devices(If low voltage) <br /> • c <br /> Description of Work to Be Done: . /,/,,,, _//, i./_/. _. A ./✓lam .,./ /7 j <br /> Aiii. //_! • '1�.41,011117 �/ . _.....e., /' ./ 41/ _. <br /> / / <br /> FEE . <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 14/a y e, <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 constriction or the <br /> performance of construction, That I am authorized by the owner of this property to perform the E 1301- h <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and O� V <br /> 296.200 WAC. <br /> 'r nature /�/ Date ' <br /> T/��-� �f�f"ecr/2r <br /> ,I GENERAL CONSTRUCTION COMPANY <br /> REVISED tvrs 7 v�ai p <br /> 473-2%-6944-'FAX-425. 9295-694WA 7 <br /> I/I:aBed Lg89L9CM76:0.1 311023 OT:EZ ETo?-6o-2Tdv <br />