Laserfiche WebLink
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 /> GOV <br /> dw <br /> PROJECT ADDRESS <br /> 292E &� tao BOX 3 70 � '9912-1-220732•z/� 2 1 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> 4I1��1Q��il�7~i�� ir . Z75 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> �' nIye m 9 <br /> State License Number(required) City of Everett Business License Number(required) <br /> �o2f d0o <br /> Proposed Use of Building Contract Price of Work <br /> /i R/,H6ml mFeb k/' � c� <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: -7 <br /> r <br /> FEE,,, <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 Q� <br /> 1 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 construction or the r 1 <br /> performance of construction. That I am authorized by the owner of this property to perform the E <br /> work for which application is made and l comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ynalure Date <br /> GENERAL CONSTRUCTION COMPANY <br /> P.O.BOX 46-MUKILTEO,WA 98275 <br /> REVISED 0810612014m���� ,' 425-294-6944-FAX-425-294-6947 <br />