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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 /> PROJECT ADDRESS <br /> i r.YY BPA 379t &oz�& v4- 991241-2 - . ��� ziz <br /> Owner Mail Address <br /> City State/Zip Phone <br /> cr <br /> Tenant Mail Address City State/Zlp <br /> Phone <br /> Electrical Contractor <br /> 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 none: <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> l hereby certify that I have read and examined this application and know the same to be true and ` <br /> con-act. All provisions of laws and ordinances goveming this type of work will be completed <br /> whether specified herein or not, rhe granting of a permit does not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state orlocal law regulating construction or the <br /> performance of construction. That l am authorized by the owner of this property to perforrn the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and ✓a <br /> 296.200 WAC,., r <br /> 9nature Date <br /> GENERAL CONSTRUCTION COMPANY <br /> afvrSBD veroarzo�a / R O.BOX 46-MUKILTEO,WA 9$275 <br /> 425-294-6944-FAX-425.29"947 <br /> T/Vat as L589L9Z9ZV6:01 :tu0.13 ZVZO 910Z-9T-NVr <br />