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Vow <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 /> �1/Ei2�'""tT"�PS ® �11E2��rV1/�• GoV <br /> PROJECT ADDRESS <br /> / T /90 BOX 3 707 gya4& �4 9 x/21/2 zo7 �z6- 3112-2/2 l <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mall Address City State/Zip Phone <br /> IO&X 316 Wk , 9YZ75 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 9 9az 0 5-919 <br /> State License Number(required) City of Everett Business License Number(required) <br /> 142, 5'? <br /> Proposed Use of Building Contract Price of Work <br /> A�k/to <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 /> -"if <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <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 construction or the <br /> performance of construction. That/am authorized by the owner of this property to perform the E — <br /> work for which application is made and t comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC., <br /> 4gnature Date <br /> GENERAL CONSTRUCTION COMPANY <br /> P.O.BOX 46-MUKILTEO,WA 98275 <br /> REVISE00"W2014 �� L �' 425-294-66944-FAX-425-294-6947 <br />