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I <br /> • <br /> ,D <br /> o ELECTRICAL PERMIT APPLICATION <br /> • CITY OF EVERETT PERMIT SERVICES . <br /> 3200 CEDAR STREET, EVERETT, WA 98201 • <br /> • 425-257-8810 - FAX 426257-8857—www.everettwa.org • <br /> 1 � ‘,, tib W <br /> i. <br /> PROJECT ADDRESS <br /> ,eog%cId. A Ax 370725- <br /> Owner Mall Address City State/Zip Phone <br /> - <br /> Tenant Mail Address City State iPphone _ <br /> / �X- 259�`/�/J JLP <br /> -411Y/ .�L.4 de, ..40, , '_ ,. l 9 98275 3125-291-695Z/7Z <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> • <br /> g- -iviee_e_i9)g 4) z c2,L7p <br /> .State License Number Contract Price of Work • <br /> • <br /> • <br /> Proposed'Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction,remodel or addition) <br /> • <br /> Number of devices(If low voltage) O� <br /> • <br /> Description of Work to Be Done; 'did pee7'0j4 / e <br /> / <br /> • <br /> • <br /> FE <br /> ev <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 550 <br /> I hereby certify that I have read arld 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 theE (301-0 4 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAG. 7-R, _ <br /> /3 • . <br /> / / .._ - K6e). /yI/17t5re.6EIJITrd 69 <br /> nature �Daate �,D- <br /> . gaitag v <br /> < /11144 GENERAL CONSTRUCTION COMPANY <br /> REVISED 3R0,1s �/��ryt i� Y 1 ' P. Box 46- .TFA-WA 98275 <br /> 425-294-6944-FAX <br /> 425-294 6944-FAX-FAX-425-294 6947 <br /> T/I:aaea L9BBLSZgZT76:oI =taoj3 9Z:00 ETU-60-'I11f <br />