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0 <br />125 <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 />�t/EFi_ -`f i 9 PS ® leVek 'TT W i - GOV <br />- 3 C <br />PROJECT ADDRESS <br />92EL 'T ?100 .BOX 3707 4;6 9F/22'1- 2207 JZ6• 3z1Z- Z/Z / <br />Owner Mail Address City State/Zip Phone <br />Tenant Mall Address City State/Zip Phone <br />Electrical Contractor Mail Address City State/Zip Phone <br />State License Number (required) City of Everett Business License Number (required) <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 />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 /4 <br />1 hereby certify that l 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 I am authorized by the owner of this property to perform the E D f L D <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />'e4k_ <br />/b - - <br />gnature Date - <br />�� GENERAL CONSTRUCTION COMPANY <br />REVISE�O"62014 ,/L L P.O.BOX 46-MLTI:ILTEO,WA 98275 <br />425-294-6944 -FAX - 425-294-6947 <br />• <br />