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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 /> ky�l2i✓iT�PS ® �lERu/� GOV <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mall Address City State/Zip Phone <br /> 9275 -2529� � <br /> Electrical Contractor Mail Address City State/Zlp Phone <br /> �rii/��� 98�oz o�0599 <br /> State License Number(required) City of Everett Business License Number(required) <br /> 4y:3/ 1 /0O <br /> Proposed Use of Building Contract Price of Work <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 /> U <br /> _FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ���, <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 I r <br /> performance of construction. That/am authorized by the owner of this property to perform the 1` `\ <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC._, <br /> gnature Date --- <br /> GENERAL CONSTRUCTION COMPANY I <br /> REVISED 08876/2014 P.O.BOX 46-MUKILTEO,WA 98275 ! <br /> 425-2941944-FAX-425-294-6947 <br />