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/oz.925 — 4302. Oe-)Z- � <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FA,X 425-257-8857 — www.everettwa.org <br />V�i2��`rT"� E'S ®EVC-R�"r►"ZNAr • GoV <br />PROJECT DRESS <br />/ T /O 4" 3 209 2& A)6 9 F/24-2 207 a3zl,2• 2/2 l <br />Owner Mail Address City Stale/Zip Phone <br />Tenant Mail Address City ],Q State/Zip /1C Phone <br />Electrical Contractor Mail Address City State/Zip Phone <br />_ �,�A%e4241-7 9 9--I'oz, 0-�a5 99 <br />State License Number (required) City of Everett Business License Number (required) <br />e %�, or;o <br />Proposed Use of Building Contract Price of Work <br />Ask l <br />Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br />Number of devices (If low voltage) ►►��77 �f <br />Description of Work to Be Done: <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />l hereby certify that / 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 l am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296,200 WAC. <br />4gnat+ure Date <br />GENERAL CONSTRUCTION COMPANY <br />P. O. BOX 46 - MUIQLTEO, WA 98275 <br />REVISEDORHJfiROt4 <br />E-/I�� I 425-294-6944 - FAX -425-294-6947 <br />